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PERMIT APPLICATION /' .,C) <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: PROPERTY TAX# tMIT4..0 • <br /> Ito3n : r`' Av6 SSE Z�3ca51g003["�i�?OC� I �I� Co�1�b <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER N0c0122r c INVESTM.N 7?ACL.TM1-12S Phone/E-mail 425 384. 53-6,3 /-7 <br /> Address 234e 171H ST 0103 City/State/400 A NI ESA dA 16 Z(Z 3- <br /> APPLICANT:_Owner _Owner's Agent _Contractor t ontractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR re 1 X 'R.S7bt'�TIQN State Lic.#f Txrzi 'JY SStjCity Bus.Lic.# <br /> Address aa 2 i. .3 W. &ST/AN RINST- 2-R WanDINv I(L G U;Z Phone/Email ZO(044oS 314'1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> n' � A �t�S INFOTz� GeC16..N6T <br /> '4 � ooDsaIc r Phone/E-mailiS 333 S4-/ INrr_)12..�. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $ 30/C1CD <br /> Existing Use of Building JFA2TMcN7 S HEAT SOURCE:' <br /> Proposed Use of Building Gas Electric✓/Other <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel V.-Repair_T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): RE(tiltCC- DP.IMP,Cr EP I N UR-101Z- FINIS H E Si <br /> ;SIDING- : SoF'FIT IN UNITS 10$,2013Z, SOB. gEPAn Z IN Pukc_E TeOss Ti4)L <br /> DAMpa.e @ (. r-r 308. <br /> MECHANICAL PERMIT APPLICATION I 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 /> A/C—air handling units I Toilet <br /> Forced air systems Bathtub <br /> I Gas piping I Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> I Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater I Urinal <br /> Boiler I Drinking Fountain <br /> I Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> Ducting Roof drains <br /> l Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads I I 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 authorized by the owner of this pro o perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 4 4 ffir 1 <br /> Owner/Aut ized ent Signature Date (Revised 9/2014) %14 <br />