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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 /> SITE ADDRESS: PROPERTY TAX# PE MIT# <br /> LLr Zo 4- bob ZG�Oz7 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 1L(�-( �Q�j � (�(_(� Phone/E-mail <br /> Address )1 771 71 SA jV V )0L City/State/Zip A LC7 0 04, <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 S,D p C G{C state Lic.#S &--AC\A)1 ) City Bus. Lic.# C)233�-S <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT C711 1 e5TWik; Avg- CI <br /> L OV �l �0 h Farms ��>r 61VA55c' rrz- ,t,+AA 7 ew4- <br /> Phone/E-mail JJ1ATr& S e <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building A4, 31 kkin I tJ HEAT SOURCE: <br /> Proposed Use of Building ND 6,0&fJ1;,& Gas Electric Other <br /> Building type: Single Family _Duplex_Townhouse _)C Multi-Family i 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 /> r iJ"r�JZI v2 V,: Prm-Ar�o N of �x 1 S" 7 AAo <br /> A-�to R 2lj6 SF A-001-n c Wv <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 <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 I am uthonzed 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 /> !JQMM:�;� 10115-h q-- t/> <br /> Owne r' ufhorized Agent Sig ture ID to (Revised 9/2014) <br />