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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www,everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Z •001 <br /> SITE ADDRESS: / PRO�PyERTY TAX# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent contractor —Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR -D -6 ( t;,� V L&I Lic.# 7�j-)JV 9b 7d6*,C3COE Bus. Lic.# <br /> Address 1101-1 MA jrq,�t S Phone/Email 'he111.{(e-Def hi zV.S Ile- • (f C Vil.- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT j/ / _ <br /> /i�C/ xdza�y.z- `7.,6 3J SIS 1 <br /> Phone/E-mail q.2 LQ&,0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKS <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition _Remodel _Repair_T.I.—Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> .1--✓t5 Yk-� T� �1 c',/"� S)v r'-e:T(h Z r-- GZ Ver„( /'r:�r S-<- '7 �' �a�� i`r.�t�.1`., <br /> Oc vlt6z //64,7 r-e—C, le,CC.�tNZv - <br /> MECHANICAL PE MIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace `K'then sink&disposal <br /> Gas range Dis asher <br /> Clothes dryer Clothes asher <br /> Rang6,ftood Water heater <br /> Exhaust falx,,,, Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preven <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> `10caner/Authorized Agent Signature Date (Revised 612012) <br />