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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G,(IV` 1201-001 <br /> SITE ADDRESS: . . ,: n PROPERTY TAX# PERMIT# <br /> (51 Q 6 b 7. �'v� ®pcoo��(66o2oo -ei 1� ,.o <br /> LEGAL for new construction: Short lo <br /> Plat/subbdivision�+ Lot No. (attach copy of long legal description) <br /> OWNER I2 17 L- U bet- Phone/E-mail . 2.-$ 7 tt q <br /> Address ,j/O& 5'5•15-- AU City/State/Zip V 0k- 7 (J 1 o 3 <br /> APPLICANT: °Owper _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 40/b41------"- L&I Lic.# COE Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �j <br /> 9 <br /> Phone/E-mail 2" 9 t <br /> BUILDING_PERMIT APPLICATION CONTRACT PRICE OF WORK (1lei250 - <br /> 2foSC� <br /> ExistingUse of Building ,Pi_no� HEAT SOURCE: <br /> Proposed Use of Building DI P / 1' Gas } Electric_ Other_ <br /> Building type: _Single Family >4) Duplex Townhouse._Multi-Family Commercial <br /> Type of project: New Addition y Remodel- Repair_T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided 9n the hack): <br /> id64 4P b�• <br /> Rekootet i (If- <br /> -r 'Mii j , Cgt.e <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 2. i Toilet <br /> 2. Forced air systems GA 5 'y Bathtub <br /> _ Gas piping 2 1 Lavatory(wash basin) <br /> Z Water heater C 4 s Shower <br /> Gas fireplace• Z Kitchen sink&disposal <br /> 2 Gas range 2 Dishwasher <br /> v Clothes dryer e(4I212 IG 2. Clothes washer <br /> 2 Range hood Water heater <br /> & 40 Exhaust fan _ Sink(service/bar/mop/etc.) <br /> Heat pump _ Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration 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 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 grant' g 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 pro erty 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 /> 4 lff <br /> Owner/A zed Agent Sign re D 1 <br /> o (Revised 6/2012) 14 <br />