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• • <br /> PERNUT APPLICATION <br /> BUILDING/MECHANICAL/PLUiMBING/SIGN/SPRINKLER/DEMOLI m ION <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:�/ �j n PROPERTYTAX# PE IT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> sc'Ve�,'ll� � Ute�i 51– <br /> OWNER l Phone/E-mail . •–��� <br /> Address �j 2.2a 7 blJev er is e – //o,.,/ S City/State/Zip –� � , L�aa� ��'�i- 573 1 <br /> APPLICANT:—Owner _Owner's Agent �4'Contractor —Contractor's Agent _Tenant(must Provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR >7G J y'c t,e n State Lic.#AuQ6 City Bus.Lic.#�2 y 9B Cl <br /> /�I / <br /> Address Pd. 13c • J-90G r'C'/Yl(Fcil e &f,4 C�2'q Phone/Email `� — �OOI �QQ TCsir urrQ uT. �r7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 5–Yt j3c-j t m 4– <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK w S/'I OU <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.I. Sign Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): !1 <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 I Lavatory(wash basin) <br /> I Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> G Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mop/etc. <br /> Heat pump I Backflow preventer <br /> Unit heater I Urinal <br /> � <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove I Grease trap <br /> I <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I� Other: <br /> Number of Heads f 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 forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 1 <br /> OdnerlAuthorize�rXgent Signature Date (Revised 9/2014) 1 <br />