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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: ;� y � o <br />� l.i i: i � ,'.i.��"`-�1 � �u <br />PROPERTY TAX # <br /># <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER 1�r', Vi � 4 ,J �i\` " � ��( Phone/E-mail ' � - _3 '�.J�b 'Gt" l,.)Zo J �Y � �' -� <br />Address �, 1 1 T�i �'� �' � ,)� City/State/Zip �; �� ��e , ' , �� � �(�` <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor�S A j811► _ TOflafll (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR l� v� V�S ',�" r�S��ti�L�'��1 State Lic. # City Bus. Lic. # <br />Address t � 1iJt; � �'J,.Y 4% L�/��('C,i� �l,'I �l � �� j Phone/Email � l�i�; — '� g ` ` , YV <br />TENANT BUSINESS NAME CONTACT FOR PERMIT � �� . ��Y��11�-tLI�,-�� <br />� � G} ki, �i.ile�l <br />� � � I'� '� �' ��= � _ . <br />Phone�%E-mail `��� �`t I..K'l)'�✓ ' {, � �,�, I (,yi., <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�t'�� �_ (�, SS 1� �) <br />Existing Use of Building 1`.� �d2nL�Z � <br />Proposed Use of Building i���� T�� <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition� Remodel _ Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�``�.i'nC�v � I v c;a — r1�., U� �! ) 1'��� I n �� � V� n-x r.�2s>�� <br />iJ <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� A/C — air handling units <br />I Forced air systems <br />i Gas piping <br />j Water heater <br />Gas fireplace <br />; Gas range <br />Clothes dryer <br />Range hood <br />i Exhaust fan <br />� Heat pump <br />; Unit heater <br />; Refrigeration <br />Woodstove <br />Ducting <br />i Other <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />HEAT SOURCE: <br />as� Electric� Other <br />Demolition Chan4e of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />; Shower <br />; Kitchen sink & disposal <br />j Dishwasher <br />Clothes washer <br />Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow areventer <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 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 pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�, � l <br />��' �'����� � � � �`i `� <br />�� i � i <br />Owner/l�uthorized Agent Signature Date (Revised 3/2013) <br />�� <br />