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■ ERMIT APPLICATION <br /> tl ■ ION <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.ettwa.org <br /> 2T <br /> SITE ADDRESS: PROPERTY TAX# pE - <br /> LEGAL for new construction: Short Plat/subdivision 6nLot No. (attach copy of long legal description) <br /> OWNER,M AgyPhone/E-mail <br /> lJ . <br /> Address '�� + �� City/State/Zip <br /> APPLICANT:X 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 /> CONTRACTORre"sState Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT (ZYArt�l ECL <br /> 5 t� s Or.•� e✓ Z8t2AQX-l-rrt'(�[T(JC� <br /> Phone/E-mail L`-1 Zl <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK' <br /> Existing Use of Building C01k2��J ot1 HEAT SOURCE: <br /> Proposed Use of Building OF>JS,C-,kE. Gas-Y Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family -) Commercial <br /> Type ofproject: New Addition X Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /4T- c'T 45%r• k{ArLA- L-tjQES KAb\l op, . LU e f S r I f,1 r-ty-T 4L-*---j <br /> �t�J4SF .S. Iktc.o6e5 I paepty 4146 <br /> CdvKmas, Wp"-V •itJcoo <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 Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink-&-di esai- <br /> Gas range Dishwasher <br /> Clothes d er Clothes washer <br /> Rancle hood ",`i x-i }'• ��t Water heater <br /> Exhaust fan '� Sink service/bar/mo /etc.) <br /> Heat um Backflow preventer inside bldg) <br /> Unit heater inal <br /> Boiler DrXking Fountain <br /> Refricieration Flo o rain <br /> Woodstove Grease ra <br /> Ducting Roof drai <br /> Other Medical Ga <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 /> 4with whether specified hereinQnThe 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 /> athonzed by the o ' r perty 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 /> orized Agent Signature Dat (Revised 4/2015) <br />