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• • <br /> 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: .� n P.WPERTYTAX# PERMIT <br /> / 17 All/ /` -+-1 1 <br /> / i -O3Y <br /> LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long legal description) <br /> OWNER 27.-",./ /14 //���rs- L Phone/E-mail u//� <br /> Address `���f4 <-4 /47' ? -/ City/State/Zip �--e/9 / 1"..-4/1- / g/4 <br /> APPLICANT:_Owner Owner's Agent _Contractor N.�Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR//'./1/// *L4I 2 (&.4 &I Lic.# COE Bus. Lic.# <br /> Address �j4 c' ./),"716) S� Phone/Email 7i'( / <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> // /_7 /e'/Z-'?47>- <br /> C ` Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '`%6.27),/;) <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 SprinklerDemolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /a/ // l a l � .040/ 'GL_ <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 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 /> f Boiler Drinking Fountain <br /> �/ Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I 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 /> L. <br /> Owner/Auttt oyized Int Signature Date <br /> (Revised 6/2012) <br /> G • <br />