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9ERMIT APPLICATIOP <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 /> SI DDRESS: PROPERTY TAX# IT# <br /> P R . <br /> LEGAL for new construction: Short Plat/subdivision Lot No- (attach copy of long legal description) <br /> L � <br /> OWNER oy\ f 2-AI L Phone/E-mail `�► —2—L("6 "2-0 <br /> Address 30 `Le 2 0• City/State/Zip f\/tv-lth VJA It 2-03 <br /> APPLICANT: OwnerOwner'sAgent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR r�W 1�- I—LA <br /> 1 V l ' State Lic. #"F— lQ City Bus. Lic. #0'�o2 lq 0 <br /> Le Address A dDy 3 Phone/Email�ZS= 113 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT l/1 hA b / 2— <br /> q Z-LLS II--1-11 W1 1 -7 13 <br /> Phone/E-mail I hTUo VV1�1 . CQM <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $ L4 000 <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.1. Sign Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> EO - bC) � v►-\CAC f Cka►jQ ou-� <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 I Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other 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 /> Th I am uthorize 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 /> Owner/Authorize gent Signat a Date (Revised 4/2015) <br />