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Feb. 22. 2016 9: 56AM No. 2016 P. 3 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: f PROPERTY TAX# PERMIT# <br /> .i iu uA CT. 2— CO``, ink ; 7C\r1G1) 141 I(v02-0 49 <br /> LEGAL.for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER -(C�.'\ Ch„It eArl. Pilin/E-mail L't <br /> Address �' .( 2.t_ • c (' l,Vt jt =tt L Clty/State/Li) �!v i TT frLrvY ctS:1-6)( <br /> APPLICANT: .Owner Owner's Agent Contractor Contractor's Agent _Tenant(must p,ovidse'suer ercansantemmthpnwrartoPawn the space) <br /> CONTRACTOR C-?.(ACti U.1rrk-:442. State Lic.# ')-.jt2 „City Bus.Lic.# r°;!qt„*. <br /> J <br /> Address '9: - Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1 <br /> Existing Use of Building ,,,, HEAT SOURCE: <br /> Proposed Use of Building Gas F.leclrir._ Other <br /> Building type: _Single Family Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: •_ Now Addition Remodel ItepalrT.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Adds . Altoratlon_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(ll)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> I 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 /> t Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstovo Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of i leads Other: <br /> I hereby certify that I havo read and cx;+;, r,r tide application and know tho same to he trite:sand txwed.M provision ol laws and ordlnancos povemhg This type of mak wit be comp) <br /> with whether apecitod herein lir nut.Tire yrsi;t ng of a permit does not presum,:b,giw:uulhuri(y to violate w cancel Ms provision of any other state lir iucd Lw,regulating construction <br /> 1 hat 1 n nullnwt,cd by the oNnner of this property to perform the wink fill which appicaUon 12 made and I comply with the Stitt!Cuntrrxal%s I.aW 18.27 RCW and 2ntillx0A WAC. <br /> jlcc <br /> wner/Authorized Agent Signature Date <br /> (Revised y/',Ni14) <br />