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� <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 # PERMIT # <br />, ., ,,. Z <br />.� y vi; �11 �nri ii (`.� �C. !�i iL w N �'�" .� f,' "v ,,7�'�.; L� ��c� � G`3 C?c� :i��u i. G7 I J � �6� �ii <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � ( �'��� Phone/E-mail ' �? " .35� 5 j�s(� <br />�• � <br />Address � >�� j� � (r( � � (r. ( � j �L�J ` #" 3.7.i City/State/ZiP ,� ' � ��-� ��.�3y <br />APPLICANT: _ Owner _ Owner's Agent �COIltfBCtOf _ COf1tf8C10f�S AgEflt _ TBflBflt (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR I5� Ir�'�' `Jl� JL S` i.i'� � <br />Address � �(�Li �� V�/,�SGv� rf.� <br />TENANT BUSINESS NAME <br />C�lV�b'l <br />BUILDING PERMIT APPLICATION <br />State Lic. # d � �� $'.$ �> �'' �� City Bus. Lic. # L� 7� . d'6' <br />� ��c�� Phone/Email ��� � �� p��j.� <br />CONTACT FOR PERMIT }�/`� y„ il�t«�.,5 <br />P f-e. <br />Phone/E-mail ����;;p�;�i �}� (z'! I,x�i I'��� ri5ti S'+�iVs'.C'= /k <br />CONTRACT PRICE OF WORK 5�a �•�'=' <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair _ T.I. � Sign _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� <br />�f ,t�� U�� �%a��c'� �'b ! ( � ��C;!t ;5�C4Y1 <br />J <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number # of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaust fan <br />Heat um <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />> Electric Other <br />Demolition Chanae of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this applicafion 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 />Thal 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 />,� � G�� �,,,�A„/ �� �3 r3' �� Z <br />Owner/Authorized A er�t Signature Date (Revised 9/2014) <br />