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r J � • <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 /> SITE ADDRESS: PROPERTY TAX# P MIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER '-Q(%N &- et L'4 LLC, Phone/E-mail <br /> Address k Z4 1 is f t t t , City/State/Zip t C t� J 1 "6 6) <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 /> CONTRACTOR ( f'4State Lic.# Q0J`$a�� City Bus. Lic.#ZtSc3 S`'t <br /> Address,Z,I,. C,'� . G Phone/Email n .• f J I G��� S `v1.�{yM <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> t� <br /> Wirf l 1\k C Lim ct-os� �v ���-13 3 <br /> SIJ�ki CLA" Phone/E-mail 13fe t661y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �L 00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X'Commercial <br /> Type ofproject: New Addition Remodel Repair T.I.�Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> kk\UM,v\aA- c< Ch6;r oel to kifr LAi,AV, 5liCin <br /> jvvr v,,-,LiI <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 /> 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 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 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 /> iw�njer�/A,thori ���gent Signature Date (Revised 912014) <br />