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*PERMIT APPLICATOR <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# PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address I City/State/Zip <br /> APPLICANT:—Owner _Owner's Agent Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to Op work In the space) <br /> CONTRACTOR jDK� W '� State Lic.# DC-LKSPLC C)brJZ City Bus. Lic.#C7 yQ <br /> Address Rqo �� Phone/Email <br /> TENANT BU-519M NAME CONTACT FOR PERMIT <br /> 50TQP i SC SEPIv lCE--s <br /> Phone/E-mail <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 xCommercial <br /> Type of project: _New _Addition _Remodel _Repair XT.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESQRIPTION OF WORK(additional space provided on the back): <br /> er;(OUC� f RE�ZgSM-L b .WAT-CkCtoS6 S� Pf OMGOE- VANITY S(KLK- <br /> &,ev,i3O A�-7PcAcc— c vo-H wRLL 14u r,(G srgK <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn XAlteration_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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I 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 complied <br /> with whether specified herein or not.The granting of a ermit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction ne <br /> That I am aut ze b e operty to dorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner oll2ed Agent Signature Date (Revised 412015) <br />