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I 1—.1\ITII I ni I iii i I Iv■ . <br /> BUILDING/MECIANICAL/PLUMBINGISIGNIS VINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERWES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 2� L ► r.,o S .r 664/c92, oo Jod D o v I /A lL L I D*5 B <br /> LEGAL for new construction: Short Plat/subdivision Lot No: (attach copy of long legal description) <br /> OWN ER eVeZt7 ofi -r//71� /16/7- #/e/—/—Y Phone/E-mail 2 57258yo, 911 <br /> AddressZox /5377 City/State/Zip 7 2 // 9rG 7/ <br /> APPLICANT:4 .Owner _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 /91/.0(,9,Q State Lic.# / f(5( C t9 IU)2. City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESSSNAME CONTACT FOR PERMIT, 4fnzo.yr,Ve z r/I/� <br /> ( &1I„a / 4/ PhonelE-mail '2 r 293 56//.37 y�' <br /> r <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /6.00, O <br /> Existing Use of Building 5.6.e� HEAT SOURCE: <br /> Proposed Use of Building 5�/`` • Gas_,t Electric__ Other_,_ <br /> Building type: _Single Family _Duplex� Townhouse _Multi-Family Commercial <br /> y� <br /> Type of project: New Addition Remodel Repair T.I. Sgct---Sprite Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1419 le y n&cep w <br /> MECHANICAL PERMIT APPLICATION • PL MIT 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 /> I 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 1 <br /> with whether cified 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 a tho ed b e 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 /> A-- ---..., 7)/ i f 1 S <br /> Owner/ uthorized Agent Signature Date (Revised 4/201 <br />