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� • <br /> 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.everetiwa.org <br /> SITE ADDRESS: —. PROPERTY TAX# PERM <br /> ��'-I /��1�5 .�. OC,�t�� �uctf�3'c;�- �� � <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER (�i'� ''�y�(� PhonelE-mail �'�f�(1 (�� G�'-� <br /> Address O � � �� � City/State/Zip U ��- ' �� <br /> APPLICANT:_Owner _O er's Agent �Contractor _Contractor�S A9@tlt _T6f18f1t(must provide a letter of consent frnm the owner to ' in the spa`cg <br /> CONTRACTOR �� �j � � ` G' }1C - State Lic.# � �7� � L � � City Bus. ic.# (��'� <br /> ) c �,,. <br /> Address ��'/1-,� ��` , '� `J { � ��t{I�- C � '(1YlWZt; �� Phone/Email �,�"�/ )��rj.J r ( P= �,' ��r 4,� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT /" �)� l / <br /> �' l���k C� ,_ ��1 L��IC���ic-t r ���5�;71�.�+.:� <br /> l �y�c�- <br /> Phone/E-mail "C C/ _, �� - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ' �= <br /> Existing Use of Building HEAT SOUR <br /> Proposed Use of Building Eiectric other <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> . , <br /> T e of ro ect: New Addition Remodel `�v Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRI PTION OF WORK(ad itional space provided on the back): <br /> �-�,�1"t-(.r� C� ��'t�(�. �(1.(� l c--t 1 l� <br /> V � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Aiteration_Repair <br /> Show Number(# of fixtures Show Number # of fixtures <br /> A/C-air handlin units Toilet <br /> Forced air s stems ' Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin 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[his application and know the same to be true and cortect.AII provisions of laws and ordinances goveming this type of work will be compi <br /> with whether specifi d herejq or�.The a ing 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 /> a I a authori by t �wn r f this r erty.t�pertorm the work for whi h applicaC n is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br /> „ 9����- <br /> ; , <br /> __ , , <br /> , <br /> Owner/Authorized Age ignature Date <br /> (Revised 9/2014) <br />