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MPERMIT APPLICATAq <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 88201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SIT ADDRESS: PROPERTYTAX# PERMIT# <br /> w , �AVZ IP ' Vag Oil— - 1'1`1 I —0 <br /> LEGAI for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER v -� �ilL�vt A.t�ZVLtta.'(,, Phone/E-mail T� -757-C(etc'J Iq D <br /> Address 4V City/State/Zip I J f A � <br /> APPLICANT: Owner _Owner's Agent A Contractor —Contractors Agent _Tenant(must provide a letter of consent from the owner to Op work In the space) <br /> CONTRACTOR Ci t? - --J-[PQ-6 '✓- &MJ4n — State Lic.# EVU65502-2-0 1 City Sus. Lic.# &o'74J5` <br /> Address 21,20 a)c. q02-01 Phone/Email 4Z 2�j2 j,tl <br /> _TE1qANT BUSINESS CONTACT QR PERMIT <br /> Phone/E-mail L <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (�5 <br /> Existing Use of Building 'L) HEAT SOURCE: <br /> Proposed Use of BuildingGas-)L- Electric Other <br /> Building type: Single Family _Duplex—Townhouse _Multi-Family X Commercial <br /> Type of project: _New _Addition _Remodel X Repair—T.I.—Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> (�ZWDU c 1 gt-�VaAI�E L. L►N t.T tilaAT14 (A,'l kJj',E krd-0 <br /> Pr-oc <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 /> ESPRIGas 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> NKLER <br /> Ducting Roof drains <br /> Other Medical Gas <br /> /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 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 298.200A WAC. <br /> Date (Revised <br /> Owner/Authorizg entSignature �j <br />