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9 0 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettNa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PER ITS <br /> I10 A�V /)-/'✓� e R a,a 3�� ( r <br /> LEGAL for new construction. Short Plat/subdivision Lot No _ (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address CitylState/Zip <br /> APPLICANT: _Owner Owner's Agent _Contractor K Contractors Agent _Tenant(must provide a letter or consent from the owner to do work In the space) <br /> CONTRACTOR S�S McCbgiJiC SC /GPS IL&I Lic # 50 'ZO/U -// COE Bus Lic # /q <br /> Address 3 3 3G S. n0 p <br /> / p >l? Phone/Email <br /> TENANT BUSINESS NAME CO TACT FOR PERMIT k f^GL 1�%{j u.GG <br /> rt /� L �2d 6 763'x33 1-1`1 J 1Phone/E ail 1itrA <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 I Commercial <br /> Type of project New Addition Remodel _Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WOPK(additional space provided on the back) <br /> 44�ieh <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New X-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 /> i Gas piping Lavatory(wash basin) <br /> Water heater I 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 i Backflow preventer <br /> Unit heater Unnal <br /> Boiler Drinking Fountain <br /> Refrigeration i Floor drain <br /> Woodstove Grease trap <br /> Ductin2 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 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 /> Thal I am authorized by the ow r f this property to perform the work for which application is made and I comply with the State Contractors Law 10 27 RCW and 295 200A WAC. <br /> / Z7 /S <br /> (Owril thorized A nt Signature Date (Revised 6/2012) <br />