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IPERMIT 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 /> \$SITCl —\_5- <br /> SITE <br /> E ADDRESS: PROPERTY TAX# PE MIT# <br /> Bio rubq i - oc <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER J e1je Lcv oh' Phone/E-mail <br /> Address 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,,611riletd1011-5- State Lic. # /46/1)1 Sp/Ob') 41 City Bus. Lic. #52,0 t1 , <br /> Address Phone/Email <br /> TEAANTrusTrinerNATilCt1 - ft nyl CONTACT FOR PERMIT <br /> Ed_`) <br /> 1 , t <br /> ig <br /> rD L - �1 a Z5 3 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> z, <br /> Proposed Use of Building ,1C{ILV1 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 /> at6 <br /> addin9‘ Niamey) ()&31/1_ 8014 and-/ k)oc es <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 I Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer X Clothes washer <br /> Range hood ( Water heater <br /> Exhaust fan 3 j A 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 /> 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 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 am a orized by t e 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.04, li` 23 �f <br /> Owner/Authorized Agent Si/nature Date (Revised 4/2015) <br />