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P�RMIT 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 � l P`ER�M�IT� # ��=. <br />��J (:� Ir�-f��(�{;.'til�ir� (��`i�7S 3.`)IG`Ci✓ � (/�i L/VV' � � <br />- —� - <br />LEGAL for new construction: Short PlaUsubdivision I�"'' h%'�3 �l-i�" ��C.�� Lot No: ��� (attach copy of long legal description) <br />OWNER ��`-V G�;x, ��J� �i�.,,�:�,� Phone/E�mail <br />City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent }C COf1if2CtOf _ COf1lf2CtOf�S AC]2fll _ T2118f11 (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR 4.N:�vSy ��vC�' �J'"r�U '{�Un State Lic. # L�- L+J,'i�S >-� �� ��ity Bus. Lic. # <br />Address 123�1�, j2� �/['v�'�- /�,��. /�'/`:�� .i'��- rr� �� l j` Phone/Email �� Z�-(� � 7 Z-` Z <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-maii 1��.Av .S5 �j �y�r � l C+/���� � �- � ^'�, <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK-����J <br />Existing Use of Building ,i': �. ^� �'�uv�� �v ��C.��cJ��--t� HEAT SOURCE: <br />Proposed Use of Building_-S� �C'G ��`��y n�-yc�:'kQ. 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 s ace rovided on the back : � �,�J l %� <br />P P � �(:�'+a, �` C-J1C.)`' .�C��.1� ��,7,� � Y,7 'C- t ,i �s2:`� G; s- <br />t <br />�;i � �� S �J �,�- � ;-�c�� <br />MECHAMICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C - air handling units <br />i Forced air systems <br />; Gas piping <br />Water heater <br />� Gas fireplace <br />j Gas range <br />� Clothes dryer <br />Range hood <br />� Exhaust fan <br />� Heat pump <br />Unit heater <br />I Boiler <br />j Refrigeration <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I I Toilet <br />� ; Bathtub <br />Lavatory (wash b� <br />Shower <br />Kitchen sink & di� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <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 hereirt or n t. 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 owne of this property to perf the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. t <br />, �. <br />�__ ) � - i 7- "��13 <br />Owner/Authori d Agent Signature Date (Revised 3/2013) <br />