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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 /> tjSITE ADDRESS:ev4,r g) W'1 U1) r <br /> PROPERTY TAX# PE�t (# 1 006 <br /> 11632 V11A-35"Everett,WA 98204 00442900402003 �i�- 'j(�} I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Fire Systems West State Lic.# FIRESWI140B1 City Bus. Lic.# 022919 <br /> 206 Frontage Rd N, ST C, Pacific,WA 98047 AlexK@firesystemswest.com <br /> Address 9 Phone/Email 253-833-1248 <br /> TENANTB <br /> USINESSNAME CONTACT FOR PERMIT(� <br /> 253 833fi124Ystemswest.com <br /> Phone/E-mail ��iiBUILDINGIT APPLICATION CONTRACT PRICE OF WORK $1,200 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family X Commercial <br /> Type of project: _New Addition _Remodel Repair T.I. Sign X Sprinkler Demolition^Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): Add 4 sprinklers and relocate 2for T.I. <br /> Existing response type to matchnew. <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 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(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 /> 6 Heads 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 am authorized by 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 /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />