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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEM®LITI®N <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 DESS: , �, -JP-`PERS�AX tt P MIT# ,) <br /> LEGAL for new construction. Short Plat/subdivision _ ___Lot No. (attach copy of long legal description) <br /> OWNER v tL n�Ci 4 �(`o�;�.� Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_�[_Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provioe a letter of consent from the owner to do work in the space) <br /> DI <br /> CONTRACTOR State Liu. # JvJ�i -Z*�T� ity Bus. Lic.# J0 <br /> Address/TJX �`l �f-j�//IX � ��/ Phone/Emai'G�� Z50— F5Z/ <br /> TENANT BUSIRFSTITA= CONTACT FORPERMIT <br /> Phone/E-mail OWY1 611- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7t ODS _ <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building __. Gas Electric­k- Other <br /> Building type: A Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel Repair_T I._Sign_Sprinkler Demolition -Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1Q.� r,/��- -��r.�/of s'7'��3`+'`••- c�t,�.re_ J� �1�. 1�%'^CG �"'!� � ��eR--- C.�c n�o.� f <br /> r-,-4 S Atte !Q� SMo%t c�2�CL-�-er1 (j <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration X 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 /> 2 Water heater Shower <br /> Gas fireplace J 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 /> I Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM i 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 I he 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 1 am authorized b e ov"iVth <br /> is property to perform the work4,h,;ichcation ismade and I comply with the State Contractors Law 18 27 RCW and 296.200A WAC. <br /> (Revised 4/2015) <br /> wr/Aut razed Agent Signature Date <br /> Onc <br />