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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 /> l - ov 3c)S- <br /> L c t <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address 22 City/State/Zip 5G,;#ilz,'11 t C <br /> APPLICANT:_Owner X 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 eC State Lic.# City Bus. Lic. # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 7-U�yf tn,L�� T�z G�X�7✓�C' <br /> TUY,�d�rol(k <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building cS.�. R- HEAT SOURCE: <br /> Proposed Use of Buildingf)E VC Gas X Electric_ Other <br /> Building type: X Single Family _Duplex_Townhouse _Multi-Family —Commercial <br /> Type of project: New Addition X Remodel Repair_T.1._Sign_Sprinkler_Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> eyv del k4eit(m incl. hw �4&6, br, k farf 4km dav-z, <br /> Ire-PAc'e Am� tn5�,,ll d)*,c7f W44 °yz Tf -r QeftAirP SO& <br /> r <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATIO14 <br /> Type of Project: _New_Addn XAlteration_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 /> a; ) Forced air systems Bathtub <br /> Gas piping Z Lavatory(wash basin) <br /> d Yf Water heater Shower <br /> Gas fireplace ; Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood yrs 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 j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 18.27 RCW and 296.200A WAC. <br /> c <br /> O n r/Authorize Agent Signature batV (Revised 3/2013) <br />