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� <br />LJ <br />� <br />PERiViIT APPLICATIOIV <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPFtINKLER/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 />ITE ADDRESS: PROPERTY TAX i# PE MIT # <br />�J t��� r�-c G aY�t�tU� � 1�-(-( D- D 3 <br />LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />1��YlVECdC� �6E'a (G�F'�L M�Et71Gsi �� <br />OWNER K-t-;.. Phone/E-mail {'rllG;`taG�• �.�'� �'(��Y��?Ci•b <br />Address ��j2- ��� 1�'�iE. City/State/Zip �V�'�� 1?��c d% S�(A <br />APPLICANT: _ Owner � Owner's Agent _ Contractor _ Contractor�S A98f11 _ T0112f1i (mus� provide a letle� of consent from the owner to do work in the space) <br />CONTRACTOR VC�GCK�EJGE R�►• 1�i7 G� <br />Address ���' t� � <br />. <br />nENANT BUSINESS NAME �� � ��C� ��„�,,6 <br />, ����� �� � <br />Ev�t2���i'C' — ►-i 157�✓4��1 ��U�E-S <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Citv Bus. Lic. # <br />IPhone/Email _ <br />ONTACT FOR PERMIT <br />r�v� i�-► --�,a.�'1�,� 425 • Z5� • a8G8 <br />ione/E-mail ��lll'� � 'bi �'(a(�G� . G6t�'7 <br />ONTRACT PRICE OF WORK � IOD, OdD. dd <br />Existing Use of Building 4-kt�%rt�tT't� HEAT SOURCE: <br />Proposed Use of Building� fT'l�+� � 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 />1C�1 c h-L�� p-G1�aC� (� o � � }C t�7"TI �S la b`�� (C,� ��G�- �2- , °) � �- ��'•� � . <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />5how Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />I Gas oipina <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Waodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />� Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 ihe provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property pertorm the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 296.200A WAC. l I.� / <br />!/ <br />C� *��--- -7' I D - . <br />Owner/Authorized Agent Sig re Date (Revised 3/2013) <br />