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• 0 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNIS PRI NKLER/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: ., PROPERTY TAX# PERMIT� OO <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER H ttl� 1 T L L L Phone/E-mail <br /> Address 11 ? 33 2 N t City/State/Zip JbCiV/\(- WDA c1 eC f <br /> APPLICANT:—Owner _Owner's Agent -X Contractor Contractor's Agent _Tenant(mast Provide a letter of consent from the owner to do work m the space) <br /> CONTRACTOR SSC/N17 M f G j)C S�'L' I "L4 1 Lic.#-S 4U Nt-N/? 5 9�Z-Q I COE Bus. Lic.#0%-!56`1 <br /> Address 2� 0 1' 1<IP t,t SAJO-t/EA4 I.S 11 0A c7 C Zi: Phone/Email q 2j " -2 1 c 7 Z-Z <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT. <br /> 131Z1�fj WOt 13Kt <br /> S CiE kc-'A Phone/E-mail -Z I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building C L HEAT SOURCE: <br /> Proposed Use of Building �"��+� r ") f Gases'_ Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family 'k' Commercial <br /> Type of project: New Addition Remodel Repair_T.1._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> NCS.% U /A I_�o uF t P 17 t-9� C�5 P►P o-r G 4-,-,o J�tr cil;l �K <br /> M F�J Fx It A FAI-t ) .. <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 /> I A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> (y 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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration 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 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 properly 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/Authorized Agent Signature Date (Revised 6/2012) <br />