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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 /> S52q 1O.AA-Ir-e. se ooz-foa.50oo05,-lcc Yln ID <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER DA1/1 D SjLtc Phone/E-mail q2-5---5/3-F-gq Z <br /> d 5. <br /> Address d /o �� J g City/State/Zip gve ,, q g-?0 O <br /> APPLICANT:_Owner Owner's Agent b<Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR DAY c/—A)lrg plj-n(36.- 4-pi L&I Lic.#p41fNTpl--q Li 2n? COE Bus.Lic.#O1 74-111 <br /> Address 6(0//4 /3 J Aitt,a) j y ) , WA- q yos7 Phone/Email 42-5-777 14(I <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT H„''` I R cbrc <br /> Phone/E-mail 1-12...51--775-W641 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK , Go <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: a 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): pcpL.FjCE axis n 3 i i D,iei yeA)l 679-5 <br /> Her r & - u7 nt A- 'AUK LesS 6-- s 116.7" C,vAI 6 _i 74 1 . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn KAlteration_Repair Type of Project: _New_Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—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 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 by 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 296.200A WAC. <br /> 4>elZ <br /> (32--//6 L <br /> Owner/A orized Agent Signa /Date (Revised 6/2012) <br />