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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: Yd PROPERTYJAX# Fprn, <br />Ev o a o3 O6S3n 005 0�20 6 <br />LEGAL for new construction: Short Plat/subdivision Lot No._ _ (attach copy of long legal description) <br />OWNER <br />Phone/E-mail <br />Address Z�t'� <br />City/State/Zip <br />APPLICANT: Owner Owner's Agent X Contractor Contractor's Agent Tenant (must provide a letter of consent from the owner to do v ork in the space) <br />CONTRACTOR <br />State Lic. # 1kT a City Bus. Lic. # <br />Address ' 1 J v <br />Phone/Email —, <br />TENANT BUSINESS NAME <br />C NTACT FOR PERMIT <br />"Y n bYDE)a <br />Phone/E-maily — Z r Vl <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK / ZO, 00�. <br />Existing Use of Building pn HEAT SOURCE: <br />Proposed Use of Building 6�1'1 Sq2 Gas Electric_X Other <br />Building type: X Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _yNew _Addn _Alteration _Repair <br />Show Number # of fixtures <br />Type of Project: New _Addn _Alteration _Repair <br />Show Number # of fixtures <br />A/C — air handling units <br />3 i Toilet <br />I Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />1 I Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />2 <br />I. com <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 comp <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 1 am authorized b th 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 />1 ,2 6- <br />&wner/Aqture Date (Revised 9714)` \ <br />I. <br />