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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 /> SITE ADDRESS: rPROPERTY TAX# PE MIT# <br /> I /r�1 �/er ' o <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> R <br /> OWNELVA ? Phone/E-mail 9`7 —CCF2-7 <br /> Addressqq r l City/State/Zip vercw <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 \Uvy\ L State Lic.# vr466LCity JJBus. Liic.#Q q29 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail Lyq 1-t V <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building V QCT N '�'� Q HEAT SOURCE: <br /> Proposed Use of Building L\ y' �� IeAof. Gas_ Electric_ Other_ <br /> Building type: -[Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: \ New _Addition XRemodel X Repair_T.1._Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> P1,61h1&nJc ledCI-OA- tti tJO(VL <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 Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace ! Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan i 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 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 /> (Ywv� /D-� / <br /> Owner/Authorized Agent Sign re Date (Revised 3/2013) <br />