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',PERMIT APPLICATICS <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: 4 PROPERTTAX PERMIT# <br /> ( ( 0/G��vOC <br /> A/1,\ybL Dry" <br /> LEGAL for new construction:�Short Plat/subdivision Lot No. (attach copy <br /> of long legal description) <br /> ��7A <br /> OWNER��� // !/D 'J �C/7/7D 7j/�/ Phone/E-mail /2 5 /,S U : qz 7— <br /> Address/ ZD� S r 7 City/State/Zip %7 9Z2e7/-- <br /> / <br /> APPLICANT:/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 /9/1 G� State Lic. # City Bus. Lic.# -�f C //1 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT//va/Z2y #6L r// <br /> ge;7 /,G Phone/E-mail V2.J <br /> 2 93 5"6 /--17(7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 41/ I IO1: <br /> Existing Use of Building J/� HEAT SOURCE: <br /> Proposed Use of Building F/� Gas 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(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 comp) <br /> with whether s 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 construction <br /> That I are autho ed y the owner of this property to perform the work fo which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> OwnerlAuthorized Agent Signature Date (Revised 4/2015) <br />