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0 0 <br /> 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: f{ PROPERTY TAX# -7T —bs <br /> �" <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-maiTr--7�--V�—� <br /> �10 0 2toGU DU y P d /r L 9� <br /> Address Cit /State/Zi ! \ <br /> APPLICANT:—Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the own to do work in the space) <br /> CONTRACTOR �%,!f L.c� State Lic. # �v�%f/. r- �7 i�Bus. Li <br /> Address �D ,e q PhonelEm il�� <br /> TENANT BUSINESS NAME CO TACT FOR PERMIT <br /> Phone/E-mail !1'' -5�- /7/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK D <br /> Existing Use of Building �� %/ hrl C_f�' H SOURCE: <br /> Proposed Use of Building r'C�� j�t'�'rlC', Gas ElectricOther <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family _Commercial 4— <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> is14Z/ Orae i���� ,,/,)/{subssk awl ails <br /> 1)w ,r hcad e', <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: J,- 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 airs stems 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 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 comp <br /> with whether specked 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 forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 17 <br /> O�vmer/Authorized Agent Signature Date (Revised 9/2014) <br />