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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: _ PROPERTY TAX# PERMIT# <br /> /Sd " <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER jj,4 ' , C/1tl " ' Phone/E-mail 4615 O <br /> Address _ City/State/Zip <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 • State Lic.# )NAi� 41090-?e-,L- City Bus. Lic. # <br /> Address ,q3 (,)A34 v-e Su gyp• i, 962i;/ Phone/Email <br /> TENANT BUSINESS NAVE CO TACT FOR PERMIT <br /> Ca-�cr, e C C)r[ ,r Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building / HEAT SOURCE: <br /> Proposed Use of Building "TM5-" r S,PyecY Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family K Commercial <br /> Type of project: New ddition Remodel _Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �,� U,ry � �'�'�;%�� (,:D.vl/��e�jrjLJv- •��1Ec� i�r" � Ii{A^� �14' , L�S /L����/� <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 j Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> j Gas range j Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood ; Water heater <br /> Exhaust fan ! Sink (service/bar/mop/etc.) <br /> j Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of HQads 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 /> fes_ <br /> w r/Au rized Agent Signature Date (Revised 3/2013) <br />