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,PERMIT APPLICATIO. <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 /> (0 0 Et L,,.� e-� , 005/r92, D0767,0O o v l l� � l I - t'C` <br /> LEGAL for new construction:��Shhort PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER ����� lroel%1k A/77-///e/7)/ Phone/E-mail -'772-'772$TZ O yoqz z zi <br /> Address4 Z �5 7 City/State/Zip /1..47 <br /> APPLICANT:,' Owner Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a latter of consent from the owner to do work in the space) <br /> CONTRACTOR ,/9N.47G/9/e State Lic.# / +'r,>(,4 t`1 lU I Z. City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT/- ANBUSINESS/ NAME CONTACT FOR PERMIT,qNj y /T 6LT�t` <br /> `-""' ' " /` 2 Phone/E-mail V2 5- 293 56/3 rt� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /6.00, 40-0 <br /> Existing Use of Building 5-16,e HEAT SOURCE: <br /> Proposed Use of Building 5/4-/ Gas ir Electric Other <br /> Building type: Single Family _Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition X Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> L 'L; 07)i (Ali 1---- -0/civiz 6tvna <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn X 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 Bathtub <br /> Gas piping 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 Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <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 compl <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 authorize by the ow r of this property to perform the work for which application Is made and I compty with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 4!2015) <br />