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BUILDING/MECHA CAL/PLUMBING/SIGN/SP KLER/DEMOLITION <br /> IFITY OF EVERETT PERMIT SERVIC <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: �� /� r t0.... _ PROPERTY TAX# P.75#03-035 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • - s / <br /> OWNER gra. • /M i /'. Phone/E-mail 4p?j —340,5-- //..zy <br /> Address D, S 15"174 L / City/State/Zip �e/ CO 9 p20 <br /> APPLICANT:_Owner Owner's Agent l/ Contractor Contractors Agent _Tenant(must provide a leiter or consent from the owner to do werx in the space) <br /> 1 <br /> CONTRACTOR L / State Lic.# xx�./e r. 7/5Oj City Bus. Lic.#05330 j <br /> , CCCrrr '7�/ �//p ,L <br /> Address ;; (Q5 1� 464 j{7 20/ Phone/Email pCU(p-- // /— o ' ? 1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT - �7 D <br /> Phone/E-mail _,Zek,- ' �51- O,R 7� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ,.72L9-..., ,0.0 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas V" Electric Other___ <br /> Building type: Single Family Duplex Townhouse _Multi-Family Commercial <br /> Type of project: New Addition Remodel !Repair T.I._Sign Sprinkler_Demolition_Change of Use <br /> DESCC/R/IPTIO�jN�OF WORK(addi. nal space provided on the back): <br /> 04'2)(2) <br /> -)d6242 Aid-ae-0-1,1161 <br /> of <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project New_Addn t Alteration Repair Type of Project: _New Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> i A/C—air handling units i Toilet <br /> ✓' Forced air systems I 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 /> Ii { Exhaust fan Sink(service/bar/mop/etc.) <br /> i Heat pump Backflow preventer <br /> l 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 /> INumber of Heads Other: <br /> I hereby certify that I have read end 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 sting 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 auth y•'ad owner of this roperty perform work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> 411, / _16/(4 4---Y9 /,) <br /> 4., orlzed Agent lgna ure Date <br /> (Revised 9/2014) <br />