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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 /> SITE ADDRESS: PROPERTY TAX#0011 t i 3 006022 cO PE(RMITA- �l} <br /> �riy 1 i.<2.C6 Or)/ot _ 11 1 'l') [ t LI <br /> 7jc(C7i (iv'Y \ AVE-. vr�4r9�.ti0�uu/cU <br /> LEGAL for new construction: Short Plat/subdivision Set u'ttiwtA.ek, Lot No. (attach copy of long legal description) <br /> OWNER j(k� C,vCR�;1-- `L.,,`,i L Phone/E-mail <br /> Address Lic c 1-i 0.y-c- Avg City/State/Zip (5-VER-,T wA ! e,z„., i <br /> APPLICANT:_Owner _Owner's Agent f( Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR TIFA M !-tU.4-;-iA/v iCAL 1,,-S C._ State Lic.# TaAMAa+c,3 cj a City Bus. Lic.# 03(..,-,ii <br /> Address O.O i3t::. X 7 Bei AAq:ti(ZcZ, 1..4k q ,...2..7 Z Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 5' Kix. MC-6 0, .,k---\.— <br /> r1,.v iLa.- GG;r.;1C 2- 6 39C. 8Es4 B <br /> 0 1-t14-Mc:L OC'y Phone/E-mail 5;,_4`-. ,_l►ZAA-1M �i-(/11,1lc.i C3)',"--t2 rat2_. L'.,- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK S I DM az. <br /> Existing Use of Building,M'Pt GAL Orr-icier. HEAT SOURCE: <br /> Proposed Use of Building i�L ;c.A L is 71,--i cc_ 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): I N'STALL_ N;;w 7 'i i"t N% M TT <br /> AND O'X-T u-le.a _ ,, ACLcaCANFL. i VAV eca< ''r b\1C-1 Li•►G(Zj<- - tNSTAU I 73r•-"W <br /> ,/h:TSJ 515'i-li C akLi.•-J G tJA-►z i. /LZ.zoc-AirL i 1,,,lt7"s1/4:6iSi'+t cet(...+` G v f-J4 i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn jC. Alteration_Repair Type of Project: _New Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> 2 NC-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 /> 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 /> — I -- 'i' 7 .1L" I t - I 1 S' to <br /> 4 6 , t)2_, <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />