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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: I PROPERTY TAX# IT# ��,•` <br /> 5, l AU _� �_+� •� a , 5 L <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER t ���:: c_2-k Phone/E-mail <br /> Address 2-S 2-2_ l F a r� Ay K City/State/Zip �' u-�C CT n rt$2.,�,3 <br /> APPLICANT:_Owner _Owner's Agent _,.Z Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR k H State Lic.# Q-E IrA c1^ City Bus. Lic.# <br /> Address 4o L5 �7Ci ,--`i� Phone/Email a SC c CG Z <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail Z S St Lc ---s-,�3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 't, , <' <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 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 /> -�q�a &&- wakw "14ff <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 /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler 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 /> 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 /> Owner/Authorized Agent SigAature Date (Revised 3/2013) <br />