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• 0 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Ever tt, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> Lomba <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> LEGAL for new construction:/Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Oqn--7 4`-X p LL Gyclee-t)o^r Phone/E-mail ZP,(.,-- 31-7'2--W`0, r <br /> Address 32-(e-f �; �� City/State/Zip �iL1Je--" P-- r y Z op <br /> APPLICANT:kOwner _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 State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 400, Q <br /> Existing Use of Building P*,4-+-f C y S'}C r-1 HEAT SOURCE: <br /> Proposed Use of Building J Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition _Remodel _Repair_T.I._Sign_Sprinkler h Demolition —Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> A-S fie, C .i —1 Q t t+1 k'r Ire ."Ovek l dT- O'l O Y ke4 n h o 'J LY r'T1�u� ��C l'tU►� <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 I Toilet <br /> 1 Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater j 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 /> j Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler i Drinking Fountain <br /> j Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting j Roof drains <br /> Other j 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 /> Z":r � <br /> Owner/Authorized Agent Signature Da (Revised 3/1013) <br />