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4ER.MIT APPLICATIHN <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.everettwa.org <br /> SHE ADDRESS: <br /> PROPERTY TAX# P 2M �(Z- <br /> 351 1 -Oft./) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)� <br /> • <br /> OWNER M i(;ja,e,( (brashI'U Phone/E-mail'17 S - Z---52-5V3 <br /> Address S (v( (L�- 0( City/State/Zip <br /> • <br /> APPLICANT: (Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lia.# City Bus. Lic.# • <br /> Address • Phone/Email <br /> TtNANTBUSINESSTIAME CONTACT FOR PERMIT <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 Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): 1.2)e v( S[ 0 IA Se ` (.: TF- Z,c)dY k <br /> hnvwr-l- vt v I4,0L-k ' Ihrivii S P 1W +0 1 i vi,4j SPae.ei <br /> — sip, P !so3-7)2 ) <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 I Toilet <br /> Forced air systemsBathtub <br /> I <br /> Gas piping \ ` Lavatory(wash basin). <br /> a I Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas rangeDishwasher <br /> • <br /> Clothes dryer Clothes washer <br /> I Range hood Water heater <br /> I • Exhaust fan ( Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal - <br /> Boiler rinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> Ducting I 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 /> That 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 /> OwnerlAut brine. •gent Signature Date (Revised 015) <br />