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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 /> SITE ADDRESS t 1Plsu{..E A j,...e... IPROPERi1l TAX h I PX � Il 10 – <br /> LEGAL for new constnictiionn:: Short Plat/subdivision Lot No. (attach copy of long legaldescription) <br /> OWNER 0 p IA)1 ' -()(/o (Atbf,, ,c).411_cvdjhwle/E-mail <br /> Addresk t0 t,go(lexfk4 v/ y/StatefLp <br /> APPLICANT:_Owner ( Owner's Agent ^Contactor Contractor's Agent _Tenant(mugprovide a letteratconsent from the ownerto do wodr a the space) <br /> CONTRACTOR CU(3 tC�t(Aoki()IV)Cj State.Lic.# 73 gook?Pg73 I-City Bus.Lic.#571S 4' <br /> Address 55'c Aup..J6 CJ ,1,-,t cVA-LA 1 COt 90 ' Phoneffimail bcbDk$'tc-yec,,undy . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 6-4-fg-z 35- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 'qOD (pGY a,Ip/,1-a.r� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 9E112--/�-- Gas Electric Other <br /> Building type: _/Single Family —Duple ownhouse _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): <br /> -1 ino tufa- c ht* , was4A\D c claS ki fP 60-32, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project New Adds Alteration Repair Type of Project New Addn Alteration Repair <br /> Show Number(W)of fixtures Show Number 00 of fixtures <br /> NC–air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> a� Water heater Shower <br /> I Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> I Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Bacidlow 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 Al provisions of laws and ordinances governing this type of work will be comp <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 for ' application is made and I comply w it the State Contractors Law 1827 RCW and 296.200A WAC_ <br /> � 10? it <br /> Own oNzed Si nature Date (Revised 9/2014) <br />