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PERMIT APPUCATV.-A <br /> BU'L®iNG/MECHANICAL/PLUMBING/SIGNISPRINKLERI®E ®LITTON <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# PEMI <br /> 1 TT <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copyofIbng legal description) <br /> OWNER Phone/E-mail Z17 <br /> Address Zl �p I-ftL 1.'KJNC �Jt� <br /> City/St, <br /> GJ � 1� �7j <br /> APPLICANT:_Owner _Owner's Agent -&Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to op work In the space) <br /> CONTRACTOR C C,(rO-( ' S 1TS.� COQ 'rr l.� State Lic,# Ct�6A-r5J 68 it mc��� City Bus, Lic,#(�NjZ try <br /> 0LAAk1- L�J6 I?BDIL Phone/Email <br /> Address I��LU I' �f �( �0u� > <br /> CONTACT FqR PERMIT <br /> Phone/E-mail ��� I"I1��- �t2�1—Z3Co 1G29(p <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; _K_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 /> fZ L� �tRv��vR6 fWW RAS* FIA65 Om" <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 /> 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 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 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 /> (Revised 4/2015) <br /> Owner/Author gent i ature Date <br />