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PE.RMIT APPLICATi -1 <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: PROPERTYTAX# RMI # <br /> �V�w <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of Ibng 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 lettter of consent from the owner to dp work In the space) <br /> CONTRACTOR i l ��6 t�QL/�� Statte Lic.# L�� (. Y Sus. Lic.# <br /> Address Zy" .�US Z 7 ) Phone/Email <br /> TENANT BU51NESS NAME] f l ,/ / CT FOR PPPERMIT''�j <br /> Yo t 4, (ti !`.�V�' ��! C�.JL Phone/E-mail _ –t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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(ad itional zipacerow dont ck) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: —New_Addn _ Iteration_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 I jg, QL/tj GL/tClothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER 1 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 uthorized by the ner o is p perry to perform the work for which a plication' made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> In <br /> ' d gen igna ure ate l� (Revised 4/215) <br /> 0 <br />