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0 • <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 /> iG7 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER E 5 rc C Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:—Owner —)!�Owner's Agent —Contractor —Contractor's Agent _Tena nt(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 0 Vy in, State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Dila% J�t q <br /> Phone/E-mail t�7 r 2-6 C), C+I 5'I ON axJ l rl,t� D Tklai s .vie <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 11000 <br /> Existing Use of Building R e s I d Lh T;rI HEAT SOURCE: <br /> Proposed Use of Building R&5 i J C hTt u 1 Gas Electric V<_ Other <br /> Building type: >< Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New Addition _X_Remodel Repair_T.I._Sign_Sprinkler_Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): 1 ? <br /> �vty l . 11 sk1d ,Ear I.1 �')<I�l i�tG Y'atW rCt+:� bO WWOVI. T-r�1(' l✓cI� �r w� 1M0✓ �t� II b���f J �Of Q.�I�C ��Cf <br /> "hr ),/e d-C .- Il . II Unta re ih5t4(�. <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 I Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> i Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> f Unit heater j Urinal <br /> j Boiler Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads i 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 16 27 RCW and 296.200A WAC. <br /> �I1 /'caN 16 201V <br /> Owner ized Agent Signature Date (Revised 3/2013) <br />