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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: PROPERTY TAX# P WIT# <br /> 7/4/ zi7`-- -c PA & Z9 .31/Z,, �I 1Q1�C2 I L QZ ? <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER kit', l)/a Phone/E-mall +�T <br /> Address L,—/1/ l' ! j7 SF City/State/Zip EV-L-N 1.4- q g a ori) <br /> APPLICANT;_Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(mvstprovide a teeUerrof consent Sem meownerto do work in the specs) <br /> CONTRACTOR ST 4/ 1,1 y�/i State Lic.# t y� M�-� K`'i City BUS.Lic,#d of 9s 0 <br /> Address q to 01 5 i3 L �`Lc A g I to,g Phone/EmailJ0. g MZ) <br /> TENANT BUSINESS NAME b <br /> CONTACT FOR PERMIT .1 t'Y1it t3� 1. 4-4,N..V1/44I-fr1 <br /> Phone/E-mail CkA m -&_c.D 0 iA iA . ,,A A , .__1 . . GO <br /> BUILDING PERMIT APPLICATIONCONTRACT PRICE OF WORK 'is J f Q 3 0 <br /> Existing Use of Building 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 lddltion Remodel Repair T.l. Sign Sprinkler Demolition_ Change-of Use <br /> DESCRIPTION OF WORK(additional space provided on the back); <br /> \ n.aliot ct a 3 -el PI ►vq -` C50) _ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project; New Addn ` AlterationwA <br /> _Repair Type of Project! �Ne _Addn lterationR <br /> _ epair <br /> Show Number(#)of fixtures Show Number(tf)of fixtures <br /> NC—air handling units Toilet _ <br /> Forced air systems Bathtub <br /> I Gas piping Lavatory(wash basin) <br /> Water heater Shower .. <br /> Gas fireplace y _ Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood <br /> Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump V Backflow•reventer <br /> Unit heater Urinal <br /> Boiler DrinklnQFountain <br /> Refrigeration Floor drain <br /> Woodstove <br /> 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!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 wtl be comp <br /> 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 few regulating construction <br /> I am authorized by the own r of this property to perform the work for which application is made and I comply whh the Stale Contractors Lew 18,27 RCW end 296.200A WAC. <br /> 1- ' Ilo <br /> • nor/Authorized Agent Signature Pete (Revised P12014) <br />