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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: 29zo T'E.aµwa. Ave PROPERTY TAX# PERMIT# �/ <br /> t ar of Everterr Sours 76.04,,,,,vo.,4 P 15-0q.-0 D-✓ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER roil of EveIEtlT Phone/E-mail (Boo) /Z9- 708 <br /> Address 1205 Ceafruaa WAy City/State/Zip EvEaETT WA 902ot <br /> APPLICANT:_Owner _Owner's Agent 1l Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do1work in the space) <br /> CONTRACTOR I Co GE.. aeltAL Cware.,cr,c.�.3 State Lie.# E A O G='t"215 R 1 City Bus. Lie.#01-13(,59- <br /> (3,..0) 398-ZIR* <br /> Address 21tto P.z.cr,n.,a..) Loop FEcwoaLe. WA 982.46 Phone/Email <br /> J Ho wneo�/•,coco•+srR•+cToa-c....% <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 5.",g ,,t¢0 <br /> Pc.gx of Eve-eel-T. <br /> Phone/E-mail (SeweE As A ore) <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK A 13,(..0.- <br /> Existing <br /> 3,cooExisting Use of Building "/vl/tINr enJewCe (Poor Oproaartaro5) HEAT SOURCE: <br /> ,, <br /> Proposed Use of Building inv1 iwe Pear OpRaartoas ) 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-OIS'r/au. Rrao,,cOD ?.es3. a ax ciAPco.a P2evewr G2 AsscwBI.y. Pawloe Joao Fate Ce..,arwenea, <br /> Y-9r¢A..Ea., u.+,o+, 8aw Vau.ea, 1.oc.Lw4 LE..me. 14.4,,o4.ea, AIR oap );,.6..t. D6.r", t 4D,Q6. "r&Pe <br /> pz awae. aw,e.c W/ Zsu.4„no.a 8au, vaWE geP'ar 4 opree. The Rpeai. she 4r4c4eo Qxwnears . <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 /> NC—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 J, Backflow preventer <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 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 am au.= c•by the owner of this•operty 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 /> . L.!' 16/15 <br /> Owner/A orized Agent Signatur• Date (Revised 9/2014) <br />