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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 611-10q-Nit <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS i/ `�3 '44 <br /> , /D ��'f'�/���� '#v °PROPEVA)Z°; °49 cs rjM1 I l -034 <br /> LEGAL for new construction: Short Plat/subdivision p Lot No. (attach copy of long legal description) <br /> OWNER /C 6T� QL/(}/i1//6 4c/ryQ�.•/� y Phone/E-mail VZ,› 7 • 'Z Z-2— <br /> Address R7 'Eag /5'Y7 ��Jr1 G. `/"/ <br /> City/StatelZip /�" �� ��.//1Z�j 1 <br /> APPLICANT:tr/Owner Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR 6A21 !State Lic.# City Bus.Lic.# <br /> Address !Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT- ' <br /> 70'ge- <br /> Phone/E-mail 7 � 52)?,‘j,e, PDgit/C"'rti <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (9S7' <br /> Existing Use of Building J,je HEAT SOURCE: <br /> Proposed Use of Building <br /> Gas Electric t .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 /> DESCRIPTIONRI `OF WORK(additional space provided onntthe <br /> ebbaack): <br /> co/vor <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 /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping <br /> 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 I SUPPRESSION SYSTEM _ Other: <br /> nNumber of Heads Other: <br /> I hereby certify that I have read end examined this application and know the same to be true and correct.AO provisions of laws and ordinances governing this type of work wit be comp) <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 Hat o'.�.by .caner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 Rani and 296.200A WAC. <br /> /� <br /> Owner/Auth; <br /> Agent Signature Date (Revised 9/2014) <br />