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0 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE A D SS: PROPERTY TAX# PERMIT# <br /> vf� t- legirl c ISA vel12-10 --0(-4- <br /> LEGAL for new construc <br /> tion: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 7 l k Phone/E-mail �,��t (�� 7j 0 3 <br /> Address ;7,30 MA (SON City/State/Zipi�/ [ <br /> APPLICANT:_Owner Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dowork in the space) <br /> CONTRACTOR �. _ L&I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail �o o <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK l <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 X Repair_T.I. Sign_Sprinkler_Demolition _Change of Use <br /> DE CRIPTION QF WORK(aC`6-5 <br /> tiona/space rovided on the back): �� (S dil kf <br /> LL <br /> -moi IJG G3� L4(P o �t � �c E r-'A u A ps- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn XAlteration�KRepair Type of Project: _NewXAddn XAlterationXRepair <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 j Dishwasher <br /> Clothes dryer ( Clothes washer <br /> Range hood Wates 1aealac �-.._ <br /> X Exhaust fan 4LSink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> X 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 /> 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 spa ' d 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 a orize by the owner of this 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 /> /0/S1 <br /> Own u orized Age I <br /> Signature Date (Revised 6/2012) / <br />