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"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 /> SIT ADDRESS: PROPERTY TAX# PERMIT# <br /> 13 c7 (v-ri' Cn ce e r't 14 ,tit ( f[ ' 0„P\ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER (AA, t c,,, _ ` ., e Phone/E-mail <br /> Address ® Roo to 2Ofl City/State/Zip 1 p WAX,' A /S q01 <br /> APPLICANT: Owner Owner's Agent fr Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR /0 .-U V State Lic.# 13--y/0 irKI- //? o c - city Bus.yLic.# <br /> Address 2.2. -Z S j BPS INA. (9/?re Phone/Email 4 7< ”-g 2 - 4-0 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 5-6 OO. ®a <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-F ily 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 /> (2Z rvn 'e.VIC, 61UCn t-tp 0 v\ 1—. CT& 6I Z �. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn fr4Iteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems • Bathtub <br /> ( Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> • <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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> • <br /> Refrigeration • Floor drain <br /> Woodstove Grease trap <br /> I/ Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM Other: <br /> • <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 thorized b 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. <br /> //-/a-/S� �I z <br /> Owner Authorised Aaent Sign e Date (Revised 4/2015)/ <br />