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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: oC Q% R V � d IU 1 PROPERTY TAX# <br /> LEGAL for new construction: Short Plat/subdivision \J Lot No. (attach copy of long legal description) <br /> OWNER otr S eW Phone/E-mail 300 1(P43 - <br /> Address a s�50 mt S City/State/Zip E'\1ere:w a2 D 3 <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 S State Lic.# . <br /> I L. City Bus. Liic.#6 (0 <br /> (6is( <br /> Address 3 10� /h,� ve ���� vi pZ01 Phone/Email 4015 `7924 -2150k <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> O7 ) 5Week\ C\wc6koAe �v�G �,��t� Ca�zzo $-og9(9 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 45W,00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family--> Zommercial <br /> Type of project: New Addition Remodel Repair_T.1._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �Gvl� ; �J- Wail <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 /> j Gas range Dishwasher <br /> j Clothes dryer j Clothes washer <br /> Range hood j Water heater <br /> j Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump j Backflow preventer <br /> Unit heater i Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting j Roof drains <br /> Other C%i r, tr. I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 a 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 /> � \I <br /> O ner/A tho ized Agent ignature D e (Revised 3/2013) <br />