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0 0 <br /> PERMIT APPLICATION <br /> B-ILbING/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 /> SI RES : e PROPERTY TAX# PERMIT,# <br /> AAa <br /> LEGAL for new construction: <br /> construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER MIll VY-- �S Phone/E-mail — ?hc1/ —2-11 <br /> 1 `jI h <br /> Address-2-LI v C �WS' City/State/Zip F ve ✓e�1yV a !/V 3 <br /> APPLICANT:_Owner _Owner's Agent ContractorContractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR U-t Aawq- ft^fmei tate Lic. #f3LUFF r Ff+9(6_113City Bus. Lic. # 0 <br /> Address 21-o'r" V� v ✓ �+ " �}— V Phone/Email <br /> TENANT BUSINESS NAME CONN7 l CONTACT FOR PERMIT �A r/t o h (Z <br /> Phone/E-mail ►1 I V?�/r tAvl c L D <br /> ►tcFo•+. L d f� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 ofproject: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 airs stems 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 inside bldg) <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 / SUPPRESSION SYSTEM 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 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 am aythorized t 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 /> Q U (2 ( ?-q <br /> Owner/Authorize nt Signature Date (Revised 4/2015) <br />