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• • <br />PEFZMIT APPLICATION <br />BUILDIIVG/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 />E ADDRESS: <br />i ��, <br />:�_ � �� � ;� c,� ��� � <br />3AL for new construction: Short Plat/subdivision <br />OWNER {�� ,:-, , �c c^�� �� !. � <br />Address � � � � �y� C � �; �' .� r_.�; '� <br />APPLICANT: _ Owner _ Owner's Agent V'Contractor <br />CONTRACTOR � �� � f.R-�,- �v:-, �r-:2„ { � <br />Address . ' 1 <br />� 1;_�; . <br />J� � P �r � � ti�:���".� , 4++ f f'e, <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />PROPERTYTAX # <br />Lot No. <br />Phone/E-mail <br />RMIT,# <br />(attach copy of long legal description) <br />0 <br />�City/State/Zip J��,��r �i � , `� �.'�'"E,;. <br />_ Contractor�5 Ag@I1l _ T2lleflt (must provide a letter of consent from lhe owner to do work in the space) <br />State Lic. # ���`'� � ! `� -`�'� � �� ���City Bus. Lic. # O Z'� z* <br />7 r'. �(,'O �I � � �� _ <br />!,�`�'! Phone/Email�'lM(C«�rs�^.FF�� �'�° ^m.F� <br />CONTACT FOR PERMIT <br />ione/E-mail '�_i',' � <br />ONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building � <br />Building type: _ Single Family _ Duplex _Townhouse L Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _ <br />DF_SCRlPTION OF WORK (additional space provided on the back) : <br />�'�'.I'bt(1 �-•{����,�/ir.� i`.����I,,v� _�. l��.r'.� ._'�... �s . ,n�l ��t. r .� - _ <br />� � ,, .. � <br />� / + <br />.� ���, �r, .-� , , , . <br />.� � c �f <br />.7 i'!� � E � t V��� 1'y f", � ' �'.' r_ ���e�' � r �e:e,. , . <br />� . , �'��f��?�f�r �i -Cal r:- . - . . . • �,, r:., . . . ._. <br />!✓. ��U <br />HEAT SOURCE: <br />_ Electric Other_ <br />olition Change of Use <br />. � � r, '�. .. -` I <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 fixfures <br />i A/C — air handling units 1 Toilet <br />( Forced air systems Bathtub <br />Gas piping I j Lavatory (wash basin) <br />Water heater ! Shower <br />i Gas fireplace � Kitchen sink & disposal <br />! Gas range Dishwasher <br />� Clothes drver i Clothes washer <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� Kerngeration <br />� Woodstove <br />i Ducting <br />i Other <br />RINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />j Water heater <br />Sink (service/bar/mop/etc.) <br />' Backflow preventer <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 compiied <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 authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�� <br />��_.� �Y ' � <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />