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OERMIT APPLICATI010 <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 /> ic -7 SITE ADDRESS: PROPERTY TAX# PER IT# <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER 5 ,.,—/f L. j Phone/E-mail (yZS J 5 ,– <br /> Address 2 Q GJ f Z t� I L 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 �'(/ !/>(� - State Lic.# L� _ City Bus. Lic.#� <br /> J PhonelEmail 1141.04-1 L� <br /> Address — <br /> �� LC cam' ��nGL+a.ccdvi <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 5 / tel ;s4r <br /> RY Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK a S <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 WQRK(additional space provided on the back): <br /> OF UAU <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 Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler j 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 erty 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 /> Owner/) orized Agent Sig ure Date (Revised 3/2013) <br />