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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: PROPERTY TAX# PERMIT# <br /> 0/,-, 3 0 2c�o �a0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER flr [y (J j{f Phone/E-mail T .�5. �-3S 33 <br /> Address 00b c�QAA=r� 15�• City/State/Zip F�� G� . ,,A/A <br /> APPLICANT:_Owner _Owner's Agent AContractor _Contractor's Agent _Tenant(must provide a letter ofconsent from the owner to do work in the space) <br /> CONTRACTOR " •�5WV5 IL&I Lic.# TD42 5,;',5 flf d ,a COE Bus. Lic.# <br /> Address ( LJ 6,e () -0 1h,,4 q0,r, Phone/Email _lam W -1` C(0 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT TW__A_,-J)� � c.IL�cY�► <br /> Phone/E-mail %( Zf- '5-D<6 - L4'7- dt f S.0 Adz <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building a/? 1:Aefye— fJ A" Gas_ Electric_ Other_ <br /> Building type: 4 Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair_T.1._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): P�14�4 <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 /> 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 7 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 /> Own Authonzed A ent Srgna u Date (Revised 6/2012) 12— <br />