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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 ADDRESS: <br /> l L/A /��1,7 PROPERTY TAX# P RMIT <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ZL�rC- T� Jr///V <br /> svi�D/�/ Phone/E-mail <br /> W5:-1-5-- 92 Z_Z <br /> /7 <br /> Address b0X- ,'S V‘7 <br /> City/State/ZipZ.---/e'7,6'77-7,- ;�/4' ��< 06 <br /> APPLICANT: VOwner Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 67/M State Lic.# City Bus. Lic.# <br /> — <br /> Address Phone/Email <br /> TENANT BUSINESS <br /> SS NAME _/�/ CONTACT FOR� PERMIT, 9 / /7,/,..--7-2 --- <br /> / <br /> ✓/ �" <br /> �/�.! 1A //� `"' Phone/E-mail/1.5.52',67: -5?0 ‘Q,v/v`. --wi •a - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 5:‘�,j cfi <br /> Existing Use of Building 5I-,P 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.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �/�/1/6 - f/T• , t2 /4- --7/L ---,(---- <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 air systems Bathtub <br /> Gas piping Lavatory <br /> ry(wash basin) <br /> Water heater <br /> _ 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 /> 1 Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> 1 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 a th ' ed by 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 296.200A WAC. <br /> /..:// <br /> Ownerl o zed Agent Signature Date <br /> (Revised 9/2014) <br />