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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 425-257-8857ere t�vagrg `W <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��`` �� J5 <br /> SITE ADDRESS: 1701 '3 r 1 S+ J. - PROPERTY TAX# PER 211 —002 <br /> LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long legal description) <br /> OWNER 041T K G K r4-f5 Phone/E-mail <br /> 4 <br /> Address 17 0 I (,3rd 5+ S t 4 tA,`• A City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent kontractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ila C. B 1-0 IL& I Lic.# COE Bus. Lic.# <br /> Address 1000 SU') 3ti-ft, 5-1- Kedd„i W A 9055 (Phone/Email(yZS) C56-osoo <br /> TENANT BUSINESS NAME .54I. H r CONTACT FOR PERMIT I� / I ' <br /> Phone/E-mail( Z5) 306— ( �&J/U '� ne <br /> M M <br /> 1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 21 !!!Attu . 99 <br /> Existing Use of Building /{iv►14-it room; t r HEAT SOURCE: <br /> Proposed Use of Building swim e_ 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): jgepk'r Sv+roke_ i wa+er pc.w+v5G Cow.see <br /> RetEMvX <br /> + T e. /9n 'Es4-Tvtq sire -D„,e„ e4 �loor S,^pporT_ igem1'ti 1 „,,4too.,1'r'Asses lock+e4 Above¢ 'Cil re Ter*°ieZ L4 0):1•1 Replace1 Like. Ro; like. R¢Plo,-e_ <br /> D,, ,,.loll A• ciT.+s,A,LA.+io•1 .Tit d�•4+.aje- Aie &e Alo Tr,cteate TA h4t or GbN„ , <br /> Xil irDoi- Ptin,h. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration A...Repair Type of Project: _New Addn Alteration epair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units ZToilet <br /> I <br /> Forced air systems 2 Bathtub <br /> Gas piping t ( Lavatory(wash basin) _ <br /> I I Water heater I Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range I ( Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood ,___t- ---- Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> 6, Unit heater I 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 I 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 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 au orized by the. nerof thi ,".perty 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 /> Zlrid, <br /> fla3 ' <br /> (21.... <br /> 0 n r/AJrorized Agent Signature Date (Revised 6/2012) <br />