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•ERMIT APPLICATIO• <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 R IT <br /> lZ-Q( <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_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 fel p , State Lic.# F\(/VI l J 1/40,f City Bus. Lic.# 013237 <br /> Address Phone/Email 2 3-- 25 -73qa. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT c F+4c.0 <br /> ( PC. 2e . 3? 30.7z <br /> Phone/E-mail l<%Aetas a7 €C'�M.�/L.Cu=°✓1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Sa <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 _Addition _Remodel _Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Cce hcc.2.4"14.e.crt�-i (407 �c-c.4--er h' k iQe,ag. e nv <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 /> A/C—air handling units ; Toilet <br /> Forced air systems ( Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater J Shower <br /> Gas fireplace I 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 I Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> F Ducting f Roof drains <br /> sj: ( Other_(1,�( , t �(a:.•, Ttt_ue Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 togive 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 /> BIZ <br /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />