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..,.. 4. )- 11 (0 t-f 3 <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.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMIT <br /> 13710 5101'''SI-SWeverek WA ` 5203 IIII- t01 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER art 9,12.eveS Phone/E-mail {jQ- 310• 311 1 <br /> Address 132.10 soy, S+: SW City/State/Zip eV ere142 WA 1203 <br /> APPLICANT:_Owner Owner's Agent VContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR lbaf \-1 e <br /> ,3rli State Lic.# IMI2g0H A 1-19C)1 City Bus.Lic.#OSaLflb <br /> Address 6100 i u ii G lik,04 RynetGl),e Ltizi 'i8 -I 8 Phone/Email1o10 Ui 31 <br /> lnPjah ' <br /> TENANT BUSINESS NAME <br /> CONTACT FOR PERMIT <br /> • <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK i. Of`l0S•00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of BuildingBGas ' Electric Other <br /> Building type: % Single Family _Duplex_Townhouse_Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel V Repair T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> \1YwhA.u} +- wAlkA/ A.LAA'W-} <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 /> NC—air handling units Toilet <br /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> 1 Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer . <br /> Range hoodWateriatatel� <br /> 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 ather: <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 her,".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 /> Crt, /m authorized by t -owner, thisi.perty 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 /> ,41•101 ! <br /> Owne uthorized Agent-ignature <br /> 0'30 901-7 <br /> Date (Revised 9/2014) <br />