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•PERMT APPUaCA I ,_ Ii <br /> BUILDING/MECHANICAL/PLUIIIBING/SION/SPI INKLER/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 AD DRESS• PROPERTYTAX ff IERN # <br /> j IIoc4L o.r l,t. CUT • ��� I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of!Ong legal description) <br /> OWNER Vr1 A Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner _Owner's Agent _Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR 4 II se,-4 06'15 f-• State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> 1 . <br /> Existing Use of Building HEAT SOURCE: <br /> • <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> 1 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 /> • <br /> 3/L+ t l m -cy Vlivi <-_- 1/1/t v l w Cy i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT PLICATION <br /> Type of Project: New_Addn _Alteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping 1 Lavatory(wash basin). <br /> Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer • <br /> Range hood Water heater <br /> Exhaust fan 1 Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal - <br /> Boiler Drinking Fountain <br /> Refrigeration 1 Floor drain <br /> Woodstove 1 Grease trap <br /> Ducting 1 Roof drains <br /> Other Medical Gas r <br /> SPRINKLER / SUPPRESSION SYSTEM 1 z <br /> Other: '(4 I t WA>L'W Ce/V1/17-P-- <br /> 1 Number of Heads Other: . <br /> I hereby rtify that I have read and examined this application and k ow the sa u-to be true and correcL All provisions of laws and ordinances governing this type of work will be complied <br /> with wheth specified herein or not.T granting of a permit..,'not p/• e to give authority io violate or cancel the provision of any other state or local law regulating construction <br /> That I am a thorized by the owne is property to pert.- the • •r which applica on is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> wner/Authorized Agent Signature to (Revised 4/2015) <br />