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PE• <br /> RMIT APPLIC; TIU <br /> BUILDING/MECHANICAL/PLUMBING/SICK/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 /> PROPERTY TAX# PERMIT# <br /> SITE ADDRESS: 231 (1 • D I I•31 0 SCO' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach_ copy of <br /> LI-FE,of Ibng legal description) <br /> �V1 M <br /> OWNER Jef i CI,1 c� 4Z-/5 Phone/E-mail -Z! <br /> Address C I I 1 "1r rand Ave_ City/State/Zip /�;(/E 4 t �\ A <br /> APPLICANT: )Owner _Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR J�./ Cci r`7/ i L(__ t t tate Lic.# City Bus. Lic.#N1/41324 <br /> • <br /> Address <br /> Y • Phone/Email <br /> TENANTBUSINESS NAME CONTACT FOR PERMIT <br /> r/t'_ 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: New _Addition _Remodel _Repair__T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <br /> Demo ext 5-t-1 n CalTo l vi G is - circ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration Repair Type of Project: _New_Adds 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 1 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 I 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 I Roof drains • <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: • <br /> I hereby certif that I have - = --•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 hether pecifie• erein or not. •e 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 /> Il••at - t rize•by the owner of thi• •roperty 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 /> Owi Autho ized •gen Signature ic <br /> Date (Revised 4/2015) <br /> • \ 12, <br />