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*ERMIT APPLICATIA <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# P RMIT# <br /> G,cr� ME2�c �t. C>2e'� Lw 2 o-1102603 0i?-00 1 0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �,O1 -7,,C, L.� , / Phone/E-mail <br /> Address j 06 ��. D i�J VV 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 A State Lic.# A X lf—}A t"( ;City Bus. Lic.# 74 ''L <br /> Address 7855 5 S LOCI <br /> %/J'�u �V l7 hone/Email Z <br /> TENANT BUSINESS NAME v CONTACT FOR PERMIT <br /> —A V V Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building A'.(L17t-A f C Mi1cilit- J I� HEAT SOURCE: <br /> Proposed Use of Building A,1L Pt,/-)(JC M"cX Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family x Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin )(,Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(addditional space provided on the back): <br /> + ^ 0 r /► �s G� C <br /> f)CO t \i 'LAO C,Ic—-- Imo' <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 /> ! <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/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 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 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 /> A <br /> Own Authorized Agent Signature Date (Revised 9/2014) <br />