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PERMIT APPLI ATI <br /> C O <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 /> SITEADDRPRQPERTY TAX PUNT(70 Tcc,' / Yr' VOD27 I D /D <br /> LEGAL for new construction: Short Plat/subdivisionr k Ye.:r•k•/ .[ <br /> Lot Noil (attach copy of long legal description) <br /> OWNER a+L, S+VO/J1/4 Phone/E-mail 4/2s -2,9o - /c 7y <br /> Address 5L/6 'fel Ave. City/State/Zip Eve C e++ V3A 9 '2O, <br /> APPLICANT:_Owner Owner's Agent X Contractor _Contractors Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR TA 6 d e_'11‘,0 + State Lic.#� �� e /11 901 a City Bus. Lic.# <br /> Addressz 7`�/ 7'�f� p N4 97_ Phone/Email 366--C29—g2 E?c <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: Single Family _Duplex_Townhouse Multi-Family Commercial <br /> Type of project: X New Addition _Remodel _Repair_T.I. Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): t�on%S'--C�C� /J�w �Cc_� 0,6 '7LA <br /> Ci-r fO%‘_S .- <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 air systems Bathtub <br /> Gas piping j Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <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 a authorize;b 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 /> /0 <br /> Owner/Authorized gent Signature Date (Revised 9/2014) <br /> 1 <br />