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r L F\ VIII hr r L_I%.,0 <br /> BUILDING/MEC•NICALIPLUMBINGISIGNIWINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SER ES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: Ur PROPERTY TAX# PERMIT#-, .� t ao/ z, oo/od vov i"1 /So -d S 7 <br /> LEGAL for new construction: Short Plat/subdivision Lot No: (attach copy of long legal description) <br /> OWNER-V6,07 /��%Sh/O //677-14/2/7->1 Phone/E-mail -.Y2G 51-2.5 yo, qZ Z LTJ <br /> Address .&X /� 7 City/State/Zip <br /> APPLICANT:,X Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a tetter of consent from the owner to do work In the space) <br /> CONTRACTOR / /✓OG,q, 1-State Lic.# 4-1-1r>e.,A-C tct 1(71 Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANTJBUSINESS NAME CONTACT FOR PERMIT /iAz .y Tn <br /> 6-Z /f <br /> / /1/ua v/-ri Phone/E-mail 2/\s- 293 5-6 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK / C 0. 61-0 <br /> Existing Use of Building J�iCiC HEAT SOURCE: <br /> Proposed Use of Building 5-F/` • Gas X 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 /> 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 (servicelbar/mop/etc.) <br /> Heat pump Backflow .reventer inside bid.) <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 <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 constn <br /> That I am authorized 4'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 298.200A WAC <br /> 21/ <br /> Owner/Authorized Agent Signature Date (Revised 4/20' <br />