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ERMIT APPLICATICO <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.org <br /> SIT DDRESS: PROPER TAX# P RMI # . <br /> llfyiawltC.� ©2- l <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; ii `/ 6 ` ` <br /> r v edietlecoC <br /> 1 i�t, <br /> APPLICANT: Owner _Owner's Agent 1i Contractor _Contractor's Agent _Tenant(must pr nsent from the o r to dp work in the space) <br /> CONTRACTOR / State Lic.# Bus. Lic. <br /> Address Phone/Email G l <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> e <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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._Sign_Sprinkler iDemolition_Change of Use <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 Toilet <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 preventer(inside bldg) <br /> Unit heater Urinal <br /> BoilerDrinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I 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 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 /> TW I am authorized by the owner of this property 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 /> C_ r <br /> 2,Lh�•� <br /> Owner/Authorized Ag `fit Sign ure ate (Revised 4/2015) <br /> OW, � Qd"I- <br /> Ilz <br />