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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: 56zZ CA-0 a. S .----" PROPERTY TAX <br /> P�l <br /> oayoTOO l#0 <br /> 3 'OG2O <br /> LEGAL for new construction Short Plat/subdivision Lot No (attach copy of long legal descnption) <br /> OWNER C` i,L ‘1Q, c).!-\ Phone/E ma:I 12_. 1131 <br /> Address $SZ 2 C11.4 `i s City/State/Zip 11,0 \k CN2lyg <br /> APPLICANT:—Owner Owner's Agent )(..Contractor _Contractors Agent / Tenant;must pwno.ae a leve,or consen,fro,Ina MOM'to no o)r .0 tho spacoi <br /> CONTRACTOR 9j`la(1 . \JOS .l, P,,-0.---- State Lic.# 1��'�, " ' ty Bus.Lic.# .51 5L--I <br /> Address ` ,(�1 LW) P L (1( E) CVA Phone/Email (i7 glf. 2,04( <br /> f <br /> TENANT BUSINESS NAME C )NTTAJCT FOR PERMIT <br /> Phone/E-mail '4Z.s SA ? (l(t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 19 o v <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex Townhouse _Mutti-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- a l.S, a6•!. o,A s ava .l.Q w/ if\ J Vh C_ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: Now_Addn *rAiteration_Repair Type of Project. New_Adds _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> 11 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 /> f 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.As provisions of laws and ordinances governing this type of work we be carpi <br /> with whether specified herein or not.The granting of it does not press we authomy to violate orcancet the provision of any other slate or local law regulating construction <br /> That l am authonz d by the er is property or which ap icafon s made and I comply with the State Contractors Law 18 27 RCW and 298.200A WAC <br /> Owner/Authorized ent SI re D to (Revised 9/2014) <br />