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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 <br /> SITT ADDRESS: PROPERTY TAX# O� ,) PERMIT# <br /> r f V <br /> LEGAL for new construction: hort Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER N Phone/E-mail 7 S- / -// <br /> Address �,� �t City/State/Zip ` � H/ ZL <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must providea tetter of consent from the owner to do work in the space) <br /> CONTRACTOR L/( L&I Lic.# COE Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> LI Y✓) Phone/E-mail y — L <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK O� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building cfa L S Gas_ Electric_ Other <br /> ily _ <br /> Building type: 4 Single FamDuplex_Townhouse —Multi-Family —Commercial <br /> Type of project: New Addition emodel Repair_T.I._Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF W(�RK(additional sp ce provided onfhe back): <br /> �� �►�!�✓ PGYG art/ <br /> 'I`e(✓ t✓(-CC.E hmo Oq "-01 'r'r G� /Me <br /> MECHANICAL PERMIT 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 2 Bathtub <br /> Gas piping 4- Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer ( Clothes washer <br /> t Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <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 state or local law regulating construction <br /> That I am authori 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 /> rlk� (�V V/1 <br /> 0 <br /> ne thorized Agent Signatu ate//� 3 (Revised 6/2012) 1 (� <br />