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w 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_everettvva.org <br /> S5E8D�RESS: 1 � PROPERTY TAXA PERMIT A <br /> j"b ,t S ,i t� <br /> LEGAL for new construction: Short Platlsubdwision Lot No. (,,it13Ch copy of long legal d(.,scrlptlnn) <br /> OWNER �" t f pn �dcp <br /> hone/E-mail ,`�-5 l� - ,4 <br /> Addross ltytSlata/Zip <br /> APPLICANT:_Owner Owners Agent Contractor _Contractor's Agani _Tenant pmust pro-loo a letter of conaant from the owner to do work In ne/nsp�ac?) <br /> CONTRACTOR State Lic.t# �`"1 city Bus, Lic.# <br /> Address a1 �+ ` J Q V$ Phone/Email `pip •Ot 'T tS �� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT JaA rt-%14 o0 ltfAAr\�t -at-�'1 <br /> phony/E-mail O'A m'(-Lcc �.o <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK( 15�2—)q� <br /> ExiSting Use of Building_ HEAT SOURCE: <br /> Proposed Use of Building C;2-kX Electric_ Other <br /> Building type: ngle Farniiy _Duplex_Tow ho MUltl-Family —Commercial <br /> Type of project New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK{ ddit enol space provided on t e beck): <br /> ( Qr ,L £ XI Q0. S r- <br /> " <br /> c•c_ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn —Alter atl epair Type of Project: _New`Addn —Alteratillllepalr <br /> Show Number ti of fixtures Show Number ak of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> GaS Piping Lavatory (wash bash <br /> { Water heater Shower <br /> Gas fire hate Kitchen sink &disposal <br /> Gas range Dishwasher <br /> Cloches d er Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/Dar/mo lett, <br /> Heat pump Backnow preventer <br /> Unit heater Urinol <br /> Boiler Drinking Fountain <br /> Refri Eration Floor drain <br /> Woodstove Grease try <br /> buctlnp Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other- <br /> Number <br /> therNumber of Hsads Other; <br /> I hereby certify Lhat I have rend and examined this application and know the same to be true and correct.All provisions of lgwS and ordinance'.governing thle'.ype of work will be comp <br /> whether specffied herein or not,The grentlnq of a permit doea not presume to give authority to violafn orcanr-ol tho provision of any other state or Inc6l Igw rrqulal ng construction <br /> The I im authorized by the own r of Lhis property to perform the ork.roc w:LCh appilcotlon h made and I rnmply wilh the Siatc Contractors Law 18,27 RCw and 296,7,aaA WAC. <br /> I <br /> ner/Authorized Agent Signature Daie <br /> (Revise(y9/2094) <br />