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PERMIT APPLICATION <br /> BUILD1 NG!MECHANICAL!PLUMBING/SIG NISPRINKLERIDEMOLITIGN <br /> CITY OF EVERETi`PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> IT DRESS: ( ` PRO�${O`JRTY TAX� b91 t OO i <br /> 0 �tJ cas 'cn � ( { i <br /> LEGAL for new construction: Short Plat/subdivision___._..........,. Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address Cily/StatelZip <br /> APPLICANT:—Owner Owner's Agent Contractor Contractor's Agent Tenant(rnust provide a letterhi of consent from me owner to do wok in tspace) <br /> CONTRACTOR Gr</V ttState Lic.# 12erCity <br /> Bus. Lic.tt <br /> Address 01 moii,,k , (. Phone/Email �P •CX a b �� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ,aA[ , m t <br /> PhonelE-mail' W ry\'t A–G+✓ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Build g Gas � Ellctric Other <br /> Building type: _ _Single Family _Duplex___,Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair ?I. Sin Sprinkler Demolition Chane of Use <br /> D RIPTION OF WORK(auditionat spale provided on the back): <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 airs stems i Bathtub <br /> Gas pi2ing Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas ran a Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood ! Water heater <br /> Exhaust fan Sink service/bar/mo letc. <br /> 4 Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> i Woodstove I 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 /> h 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 stale or local law regulating construction <br /> Tha I am authorized by th�ftfi o perform the work for which application is mads and t comply with the State Contractors Law 76.27 r2C;W and 296,200A WAG. <br /> ner/Authorized Agent Signature Date <br /> (Revised 912014) <br />