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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> RAGS S-4-4.1 five. W. ,ire-4 t_t4 l,'l ?,1 - C . 5 <br /> LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner _Owner's Agent XContractor Contractor's Agent Tenant(must provide a letter ofconsent from the owner to do work in the space) <br /> CONTRACTOR 1--1 ci.y B Y-o Q,,_ I L& I Lic.Lic # AP. 1n/ <br /> gRZ9zSLR COE Bus. Lic. # <br /> Address 000 SW +L, 54, # H te61�-0,1 W 98 055 Phone/Email elf Z ) (956,—0 SOO <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> • <br /> • <br /> rP�J.Go.rlo.r�d harbro.co»t <br /> •. A: Phone,E-mail ( i � — I4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '__�,$rsrr:r4t_t_% 'S <br /> ° r,�v►+ <br /> Existing Use of Building IN)L4 I � — I y HEAT SOURCE: <br /> Proposed Use of Building S&.J11e Gas Electric y 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 WO K(additional space provided on the back) <br /> �_P-S ICA. - A LI ¢urn �lvto1}grt -L If►s V /U42,4 ¶r e,F 4 1Roor. . <br /> �I V V!/� f _L✓ tAj C^�IOYt � W1 I.I SCOPE of WORK <br /> / I r THE FLAN REPAIRS FIRE,SMOKE AND WATER DAMAGE TO T14I5 EXISTING 4-FLEX AND 2-STORY APARTMENT BUILDING CAUSED BY A RECENT FIRE. <br /> TRE EXISTING FIRE DAMAGED TRUSS ROOF STRUCTURE MILL BE REVVED AND REPLACED IN LIKE KIND.EXISTING FIRE DAMAGED FLOOR AND <br /> EXTERIOR BALCCRY FLOOR FRAMING MEMBERS WITN BE RE OCNED AND REPLACED IN LIKE KIND.NO INRFASE IN AREA CR HEIGHT CR CHANGE OF <br /> USE i5 PROPOSED. <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 /> A/C—air handling units I 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 <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 complied <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 b the owner of this property to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> ate <br /> 0 'ey a horized Agent Signature (Revised 6/2012) <br />