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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: l _ 20 PROPERTY TAX# PERMIT# <br /> urf/1P4 :::] C t-:m-7 n0a P, <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER YN-�Qo(-e v Phone/E-mail Z.— - 2a- Lleq57C <br /> Address eO i 5 j<--)t U , Auc City/State/Zip j_,)Cr _ <br /> APPLICANT:K Owner _(O`wner'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. # City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail LI Z S--Zt, 4Sf3�t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Y 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 /> r'-^-Ja'f -Tor- pc-,--^v` 4 cc.) qoz - co -4 <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 /> j Forced air systems j Bathtub <br /> j Gas piping j Lavatory(wash basin) <br /> j Water heater j Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer ! Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> l Heat pump j Backflow preventer <br /> Unit heater j Urinal <br /> j Boiler Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove I Grease trap <br /> Ducting Roof drains <br /> Other j 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.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 /> f 7 _/ 1-5 <br /> 6wnedAuthorized Agent Signature Date (Revised 3/2013) <br />