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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: PROARTY TAX# PER IT# <br /> 'J/ 8 '' p0 c- F.-. f scYYf-z oG41 -;.'d ?) IhO&i-ON <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach) copy of long legal description) <br /> t i <br /> OWNER ,g-r/ 4. / `r IC ,p'/ Phone/E-mailrj -SW c-br en j/ Q,� c Caxi <br /> Address /7' City/State/Zip t <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ,/ 7// 2C..iJ27(-r State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT '�11 / 2 <br /> Phone/E-mail (_. 24Z; c *- •J )S <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 s )( 060. _— <br /> Existing Use of Building (ITC)/"e.- HEAT SOURCE: <br /> Proposed Use of Building 7-b Y gut,C- GasElectric Other,,1&.n/ <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 /> -Iwo Cir 9H4^A-9 <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 /> I <br /> Forced air systems Bathtub <br /> Gas piping jC. 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 /> i Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> I Boiler i Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM X 1 other: /-4-4'Lp c / <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 specif yt erein :n .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 dm author db the e o thjs prope perform the work for which application is made and I comply with-the-State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owne/Authoriz Agen ignhtulie �(�/' Date (Revised 9/2014) <br /> `�2 <br />