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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3240 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www,everettwa.org <br /> SITY $S: i� JPWPER�T� <br /> fl+ i <br /> t'i1 G ` i�!y <br /> LEGAL for new construction: Short Plat/subdivision., lot No. _ (attach copy of long legal description) <br /> OWNER -i o,, szn Phone/E-mail , <br /> Address City/State/Zip <br /> APPLICANT: Owner Owner's Agent Contractor Contractor's Agent f enant(must provide a loonr of eo,sens from me ovmer to or,work in toe space) <br /> CONTRACTOR State Lic.# j kerCityy Bus.Lir..#()d f9 C) <br /> Address of 0r^ L (_ Q 6 'V,g Phone/Email 4a ,f9 q 9 - -"+9 01:�) <br /> TENANT BUSINESS NAME CONTACT FQR PERMIT aA rn%L Wc�Y1s►1�-�1 <br /> Phone/E-mail W M'.-.-6C ) t:.O <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF w K -4711e>qq <br /> Existing Use of BuildingCE- <br /> Proposed Use of Building Gas Electric_ Other <br /> Building type: -- Simile Family _Duplex_Townhouse -___ ti-F mily Commercial <br /> Type of project New Addition Remodel Re air MulT.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> IPL�A OL C x— —t)( 1 S—�- " q CL S 0 r\A <br /> MECHANICAL PERMIT APPLI N PLUMBING PERMIT APPLICATION <br /> Type o ct: ___-New_Addn tteratio _ epalr 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 I Water heater <br /> Exhaust fan Sink servicelbarlmoptetc. <br /> Heat pump Backflow preventer <br /> Unit heater i Urinal <br /> Boiler C Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove ( Grease trap <br /> —Dcting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I 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 /> is whether specified herein.or not.The granting of a parmit dolls not p ume to give authority to violate or cancel the provision of any other state or local taw regulating construction <br /> Tha I am aulhonzed by the own r of this property to perform the work for :ich ppiicahon is made and I comply with the State Contractors Law t8-27 RCW and 295 200A WAC. <br /> neriAuthorizod Agent Signature pate <br /> (Revised 9/20 t 4) <br />