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• • <br /> PERMIT APPLICATION <br /> BUILD1 NG/MECHANICAL/PLUMBING/SIG N/S PRI NKLER/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# PER IT <br /> 3 1., %AJ C004h)-35toigoo b <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Aft, Psr k LJ- Phone/E-mail <br /> Address (1 il•- 2-411 y1 City/State/Zip W1410 99203 <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 /> CONTRACTORPJ-wisef Jf. State Lic.# p0311:1 9OUI City Bus. Lic.# <br /> Addrls,f'1 {- Alco Q 'qff2ll Phone/Email S0 q240 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail i-44 G <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ J�f�C7C� <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 of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): �7,,,5 j�ll< tin �y q ''��Ir.�sy5y(t m /��� ntt�• �+nQl <br /> 14 411, �tU AfG�� wl �k I'P�o('��tnq e><r'sJ�S �rr/la,Np�P✓��dl'� ��w prr5 �✓�trt <br /> v��rrss�fy <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 /> i 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/mo /etc. <br /> I Heat um Backflow reventer <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 stale or local law regulating construction <br /> That I am authorized by the owneroff this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br /> ll <br />