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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 AD RESS: PROPERTY TAX# PERMIT# <br /> 00-L2 `� <br /> s 0563 u i�7 7 "D <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> < f <br /> OWNER Phone/E-mail <br /> Address 2 ZG i q cr,` /�_ . -'* ,lyl,,;; City/State/Zip A:,yds' y✓J jJj'G' <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 Ck State Lic.# City Bus. Lic. # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT— f _ �� -�jt <br /> `I�G'y'11C l�t�endesr�,?-tnn fc-.� <br /> Phone/E-mail TRk' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building SF?- - D1 621 A— HEAT SOURCE: <br /> Proposed Use of Building S �' 1 lu mail Garin. �J•J� Gas Electric Other <br /> Building type: '< 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 /> f p-f oof <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 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 /> j 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 /> I 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 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 /> f <br /> Owner/Authorized Agent Signature D (Revised 3/2013) <br />