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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/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: PROPERTY TAX# <br /> AO g <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's At _Tenant(must provide a letter of consent from the owner to do work m he space) <br /> CONTRACTOR State Lic.# <br /> yL►_city Bus.Lic.# <br /> Address 1 PhonelEmail <br /> TENANT BUSINESS NAME CgqNTACT FOR PERMIT r <br /> J(SS1 inl�--� <br /> Phone/E-mail r COI <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK, C`�J <br /> Existing Use of Building 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.I. Sin Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> W f(,) heads <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 pi in <br /> E <br /> eater �_ Lavatory(wash basin) <br /> � Shower ' <br /> fireplace Kitchen sink&disposal <br /> range <br /> 1 Dishwasher <br /> dryer <br /> Clothes washer <br /> hood <br /> t fan Water heater <br /> m Sink(service/bar/mop/etc.) <br /> �_ Backflow preventer(inside bld') <br /> ter Urinal <br /> Boil <br /> ation Drinking Fountain <br /> — <br /> I Floor drain <br /> Woddstove <br /> Ductin RGrease trap <br /> Other Roof drains <br /> Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads I 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 /> 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 /> qwn /A.t <br /> uthorized by the o er of this property to perform the <br /> ork for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> orized Ag nt Signature U I Date <br /> (Revised 4/2015) '� ' <br />