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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# P_-RMIT# <br /> Icx=�t'-� � � r> 1�� Ear✓ ��<<��2G1-c�c� Z c�(��c� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER So((-)CL Phone/E-mail �142.c,) 2.3 —`34! <br /> Address IL)L)1s City/State/Zip e - C ,2L-4 <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 IC!vV►s 4�tJ0 W` . �T &I Lic.# COE Bus. Lic.# <br /> Address 1 JZ �CVV C, 1-�(f�l�lWfttt.� Phone/Email(Q'- ) <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> C;�tS�+` Qt'_Crvut_t�SSiS� �C'C1Vtctl�l �� C' >rvt <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �>>��c�`J.�{2- <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: _,k:_New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> t - <br /> DESCRIPTION OF WORK(additional space provided on the back): L� f���T�'�lC I L L 'F 24�--24 1 1`1- V-P--s -k <br /> C->l�-iz+`L-tip• <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 air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gas range Dishwasher <br /> Clothes drye Clothes was r <br /> Range ho9d Water heayr <br /> Exhaust an Sink(se Ice/bar/mop/etc.) <br /> Heat mp Back w preventer <br /> Un eater Uri I <br /> 1�6iler Qfinking Fountain <br /> 'Refrigeration 'Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SP KLER/ 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 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 /> i <br /> t ,�f <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br /> `((?o <br />