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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 /> t),,,,-, <br /> SITE ADDRESS: /.Z. - ,' t )C ' (- r, PROPERTY TAX# PERMIT# <br /> —i i4 -= V�+- ,,; - 7860601300 (1 (SO3 Dz`f <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER I \ 1 I G j. Phone/E-mail 0V VV ,/ ( (o d /(2`t„c 1, / )e" <br /> Address L 4ij-7 42,.v c , , City/State/Zip C a ("), , • <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 Cr A 13 we S 4 . State Lic. cS*QSS1 S City Bus.Lic.#WI I O 0 <br /> Address 1 2,0-7 (-IP' PJC. ' H(f vi.' Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ,' <br /> Phone/E-mail `2 7_,'S S. - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building //�� HEAT SOURCE: <br /> Proposed Use of Building C7 G%Nr- et Ct e Gas_ Electric X- Other_ <br /> Building type: X 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): (tis 0 C-1 r.j n '-• , <br /> l <br /> Qat ciy -� , ZSx, ZS <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: X 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 7 i • Toilet <br /> 1 Forced air systems I Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> I Water heater i I Shower <br /> Gas fireplace ; Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryerClothes washer <br /> Range hood <br /> I Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> j Unit heater < Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration I Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: (, k I (j s-- <br /> Number of Heads Other: <br /> 1 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 authorized bu the owner of thi prope 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 /> 3--. .9'`.S, <br /> Owner/Authorized Agen Signature Date (Revised 9/2014) <br />