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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 q -T P RMIT _ <br /> 114 o Gl,�c� l�rr Pel - <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER O L) USS_ L v O'CO Phone/E-mail L� <br /> Address Hb(, vuc� LE R City/State/Zip <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 Ho&e 77S to®(r), fe l 4tate Lic.# City Bus. Lic.# <br /> �n/ 7 �/ , <br /> Address r r © • f�t( � 't o3 gbeli 1'n m i,5a,my qg* Phone/Email �as�/2.Z-4127 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building1»,4 jL p,&,' HEAT SOURCE:, <br /> Proposed Use of Building a-a c� �ovL Gas_ Electric_�Other_ <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel J-Kepair_T.I._Sign_Sprinkler_Demolition _Change of Use <br /> DESCRIPT�?N OF WORK(additional space provided on the ba k) <br /> 1." tq <br /> '2.. w 0 <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 l Lavatory(wash basin) <br /> Water heater ( Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> I Clothes dryer j Clothes washer <br /> Range hood Water heater <br /> Exhaust fan ! Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater Urinal <br /> Boiler i Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I <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 oft roperty 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 />