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• • <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:/7c, On I ( PRo �4X n '��OO'^r PEfop')I ' O'X-04-0 <br /> 'X/_` 4-Q <br /> LEGAL for new construction: Short Plat/subdivisf n (�(�Lo((ott/t No. !J (attach copyoflongonlegal description)l `� U <br /> OWNERI JOV C1'Y21)/f eN (Phone/E-mail /N-)&. efg/42ul Idler 1Nc bli. <br /> / <br /> Address " /� ( <br /> City/State/Zip .0(Or 1 Li )14. (9 <br /> APPLICANT:_Owner _Owner's A�ent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOREbe ,_ V11 �S Wkie. L&I Lic.#9)l-_R) 301 P14 COE Bus. Lic.# <br /> Addresr g18 /4--.. --- E AO. Phone/Email OS„` <br /> ' -�- �.( —i7/? I <br /> TENANT B SINESS NAME CONTACT FOR RWT <br /> &l2 W 31CLC., . b <br /> Old Key" Phone/E-mail EuLorp" j�l nue.. I= <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I I)39(o <br /> Existing Use of Building :5 p--� HEAT S <br /> Proposed Use of BuildingG Electric er <br /> Building type: Single Family Duple Townhouse Multi-Family Commercial <br /> Type of project: k New Addition _Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1 EPrRn$ <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 /> I A/C—air handling units Toilet <br /> Forced air systems i <br /> i Bathtub <br /> I Gas piping I Lavatory (wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink& sposal <br /> a,s range Dishwasher <br /> Clot' dryer j Clothes :Sher j <br /> Range[ie.!. _Water '-ater <br /> Exhaus . service/bar/mop/etc.) <br /> Heat B. k••w preventer <br /> U ' heater drinal <br /> toilerDrinking Fou .in <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 spec' ed herei 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 /> P.- am authoriz.`by the o ner 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 /> ?...rM.--IgV.—/ <br /> 111.14 <br /> tt <br /> Own uthorize.g•nt Signa ure Date (Revised 6/2012) <br />