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Nie-1)(06 ' F <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 /> z8`O$7g190/93Z.Pi) <br /> SITE ADDRESS: PROPTAX# <br /> cos I0 I ,r, LS'ERTYo.f`/gr'/03y.0t7 PERMIT## <br /> P ,,Z{�i <br /> LEGAL for new construction: Short Plat/su6��dtvistonvF c.1^ Lot No. (attach copy of long legal description) <br /> OWNER f t41-ArZ Q,1/0 UG Phone/E-mail to z het YIN a w a tati ciG ri die kvrtteS. <br /> Address 17 Clzi tQ 1.L EVt .&tT w(/it SVITs Ii 2 City/State/Zip gor4 51A- t 1Ahar. QB 2- <br /> APPLICANT:_Owner ✓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 State Lic.# City Bus. Lic.# <br /> Address SCIANk. CIT a.b0f1'2... Phone/Email SzW Qt abDVe. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail SIM CO' IAAOVe„ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1 S Z I S O <br /> Existing Use of Ri,i-"-� �A HEAT SOURCE: <br /> Proposed Use ur buildingi,+,TrAC-44'S -11-710Gas ✓ ElectricOther_ <br /> Building type: ✓Single Family Duplex Townhouse ✓Multi-Family Commercial <br /> hype of project: ✓New _Addition _Remodel -Repair_T.I. Sign Sprinkler Demolition Change of Use <br /> iESCRIPTION OF WORK(additional space provided on the back): <br /> Nvto is wto i-tokt6 vO r F- 4 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ✓NewAddn _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 Z Bathtub <br /> Gas piping .3 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 <br /> Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump f I Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> • <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> .,,ereby 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 /> 7jOwner/Authorize ent Signature 7"; 43' tory Date (Revised 3/2013) <br />