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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: J PROPERTYTAX# PE MIT# <br /> /?j% Je L�j2TZ�J 7 1 a ),i9ytCL c% <br /> LEGAL for new construction: Short Plat/subdivisioLot No. (attach copy of long legal description) <br /> OWNER C Phone/E-mail - 3S 7j�^ 7� v� <br /> ->oc <br /> Address City/state/Zip <br /> APPLICANT:_Owner Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lic,#QL)/ 6 iCCity Sus. Lic.#Q� 8 <br /> Address acs / Phone/Email 3 U S7Z- ✓� <br /> TENANT BUSINESS NAMECONTACT J PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building��-�`{ y�� 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.1._Sign_Sprinkler_Demolition Change of Use <br /> F. <br /> DESCRIPTION OF WORK(additional space 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 EtEToilet <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 pre venter(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> a Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> F-SPfidNKLER /SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certifythat 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 a ed by the owne of this property io perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />