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• <br /> ERMIT 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# R <br /> (o2ov Iq�" A-.IE SE 0A70129P g111Ii+JT <br /> oZ_ 0UZ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Coskt o (^ d1e s,42.,,I.e..., Phone/E-mail <br /> Address gc(ct (A1Li vezAvvi City/State/Zip lSShQVAh� 4--A 1.024" <br /> APPLICANT: Owner Owner's Agent O(Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Pr.-rR1t7v Y\2tr PILoVe t1•%o"- L& 1 Lic.# PirrytIFO lei C F COE Bus. Lic.# D2q6°1/ <br /> Address 27o1 70TJ'4o/ti E 74(•",r4, 1,4 161{2-4 Phone/Email ZS)-72G-2290 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 64i-co Phone/E-mail 2.)-PPS--rivt Sok.-41 e. 19.-A'r:..4 4-;re e.Cw•- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 611?,Mq9 " <br /> Existing Use of Building (2e Ire;.\ -eej.t j 1-e HEAT SOURCE: <br /> Proposed Use of Building mak..:,\ .,..okte-i e. 4't Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair )( T.I. Sign kSprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ppO t (Lc\be.-�c ht0.0es 4, tne.) Offt-t5 CGn .0 ev •-"s‘-t."- • <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn X 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 fanSink(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 /> • <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> i 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 complied <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 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 /> Z-17-/E__ <br /> w er/Auth ' Agent Signature Date (Revised 6/2012) <br />