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0 0 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBIN G/SIGN/SPRIN KLER/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 ADDRESS: PROPERTY TAX# PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision 1 Lot No. (attach copy of long legal description) <br /> OWNER /'t cp` ucre, �iAAA <br /> 1nV�S' �1^�P��✓t/ Phone/E-mail <br /> �tv L� S <br /> Address D�� S C C�� /" A w 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 �"V�f i7 '�Xh Ie� �i'b L& I Lic.# CU��n��'�'� L�s i_�(` L COE Bus. Lic. <br /> Address-7v 1 ✓C'+ I��+l , vt S � �`C �/k �l�tc Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT w6 ,���._ [-H Li C,2W <br /> A( ` .- <br /> ` � d� �ePhone/E-mail f <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 /> V�t^� V iv it A P,,.- -f ke ,,Vs{z,vi -�,r, - N �a•,,�t- 1 t <br /> q� � 1 t f t t D1v— <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 /> 'Al Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> I Other ib.)vim- 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 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 /> LUL <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br />