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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SP RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.orcg <br /> S 7E AD E53: <br /> PROPERTY TA tf P11MIT# <br /> LEGAL for new construction; Short PlaUsubdivision <br /> Lot No. (attach copy of long legal description) <br /> OWNER 0 :�' I - ,— `✓....� <br /> Phone/E-nn <br /> Address �_� (� ,, <br /> City/Slatelzip <br /> APPLICANT: Owner _Owners Agent Contractor Contractor's Agent _Tenant(must provide a IBKer Of e0naent from the owner to QO work in the space) <br /> CONTRACTOR t. ,y I it <br /> State Lie.# h)/1 n <br /> !!'1� Citly�Bus. Lic.;x V a � d <br /> Address 01 ` -L <br /> 8 Phone/Eme91 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Q..�t'Y1 t t •W1.r�-.r1 <br /> Phone/E-mail LIA cil) <br /> BUILIDING PERMIT APPLICATION CONTRACT PRICE OF WORK 19 ZEQ q <br /> Existing Use of Building �l HEAT SOURCE: <br /> Proposed USe of Building Gas Electric other_ <br /> Building type: Single Family Duplex Townhouse MUitl-Family Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(edditlon&/specs provide4 on the back): <br /> f <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 'type of Project: _New_Addn Alteration Repair Type of Project: _New,_„Addn _Alteration_Repair <br /> Shaw Number r#J1of 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 ran a Dishwasher <br /> Clothes dryer Cloth®s washer <br /> flan a hand Water heater <br /> Exhaust fan Sink service/bartmo /etc. <br /> Neat pump Backflow preventer <br /> Unit heater Urinal <br /> Soifer Drinking Fountain <br /> Refricleration 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 applir-Winn and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will he camp <br /> nhaahether specified herein or not.The granting of a permit does not presume to glve.autnority to violate or cancel the provision of any other Vale or 10021 law regulating construction <br /> maulhorited by the owns\1r of this property to perform the work <br /> TTorw ich appliTtion is made and I co m w/i�th the estate Conlrrartors Law 1 B.2 RCW a 296.200A WAC. <br />