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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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> LEGAL for new <br /> construction: Short Plat/subdivision Lot No`.� ch copy of long legal descri tion) <br /> OWNER / � Phone/E-mail <br /> Address I �w-� /`� "c-fL— L City/State/Zip <br /> APPLICANT: Owner Owner's Agent XContrtaccttor —Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR j'1'9!+/QAAIG�` �J!-/l- bi k4,W1641 State Lic.# (,�A.1AAF.S11lo,1,TJJO City Bus. Lic.# <br /> Address 1�A C/� S� JTr86tLl U-AA �'�^ j PIdhone/Email �� f��i : tri!�1�ANF 2 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT t`,/KS" <br /> /VQANtC fA1164CA%^ <br /> Phone/E-mail Si_ <br /> y.Qw1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK j� yJ <br /> Existing Use of Building 5pF)L HEAT SOURCE: <br /> ✓ <br /> Proposed Use of Building 61— Gas xElectric Other <br /> Building type: XSingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> (a AS t—C�6 S�T1jA,16L.V161AJ4 4,A� <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 airs stems 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/mo /etc. <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other tq� RAS � 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 comp <br /> with whether specifie ereiow n 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 authorithe er 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 /> 4 <br /> Owner/Au orized A t Signature Date (Revised 9/2014) <br />