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9ERMIT APPLICAT1011 <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 /> 7—D `{S <br /> SITE ADDRESS: _ PROPERTY TAX# PERMIT# <br /> �. —OO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �? Phone/E-mail 9=-2)a\ <br /> y� <br /> Addressa NE- D� City/State/Zip n a D <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 /> CONTRA(C�TOR —N�L State Lic.#1A �5Q'Q L�City Bus. Lic.# <br /> Address c/ L5a � 1 -NH � ' Q�J Phone/Email — <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT MA,rt"' �����LJ <br /> Phone/E-mail Y l l� J <br /> BUILDING PERMIT A PLICATION CONTRACT PRICE OF WORK 9 <br /> Existing Use of BLlilding \ oQ 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.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): '2 \ AV) On VA . <br /> alt�� <br /> 0V6Q6C(qM1q(* U�6 cpry�qoa�ch No �Wocelkv\� <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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other `4k—14 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 /> : _ J LCL <br /> Owner/Authorized Agent Signature Dae (Revised 4/2015) <br />