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• • <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 <br /> PROPERTY TAX# P RMIT <br /> E �� ,n r '�,.-j��„ � ) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent _Contractor —Contractor's Agent _Tenant(must pprovivide a letter of consent from the ownerto do work in the space) <br /> CONTRACTOR �'� C�/6� State LQi�c.# eC)[C., �FPO City Bus.Lic.# <br /> Address 10� �(�� a� 3 (/ /"1 Phone/Email laa-,S-- Llal 7Z­-e�f <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Mot f Lk,-z i � � c e,-451rz <br /> ��SDG��� <br /> Phone/E-mail ye2Jr Y(P� ���Q <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.1. Sin Sprinkler, Demolition Chane of Use <br /> DESCRIPTION OF WORK(additi n space provided on the back): <br /> �a�5e 3( V QeCL <br /> �dmdc <br /> z-©40 <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 Toilet <br /> Forced airs stems Bathtub <br /> Gas piping <br /> Water heater Lavato wash basin <br /> Gas fireplace Shower <br /> � � Kitchen sink&disposal <br /> Gas range <br /> Dishwasher <br /> Clothes dryer <br /> Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump <br /> Backflow preventer inside bld <br /> Unit heater Urinal <br /> Boiler <br /> Refrigeration � DrinkingFountain <br /> stove � Floor drain <br /> Wood <br /> stove trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM I 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 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 work for which appliagtion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> O ner/Authori d Agent Signature Date (Revised 4/2015) `�� <br />