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PERMIT AP'- "4TION <br /> BUILDING/MECHANICAL/PLUMBIN4j/aiGN/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 /> q - o- 14 <br /> SITE ADDRESS: I/ S 5-3p/ 5 PROPFRTY TAX u P IT Q <br /> LEGAL lot new constructd w <br /> ion. ShoPlattsubeflsion_______ Lal No._ (attach copy of long legal description( <br /> OWNER ( rO5L PhonelE-mail SeD t_vQ��C0.5 T- .,AC <br /> Addirss 2 1rL 15 5 � I Cdy/Slale7Zlp EIrlC--11�.{ <br /> APPLICANT: XC+:ner _Owner'sAgenl ,_Contractor _Contractors Agent Tenant/must pay.deah^n crcmum a�,m�>e o.re, ,.,..,a, n•�r.-n <br /> CONTRACTOR �VM^(tcQ IRS 1-TWA hA 5 Stale Lic.It V /U Cit Bus.Lic.a () 9 L'15 <br /> Address r SUN 99 SF ,to 1 vi W2'cu��10� PhorlbrEm aA <br /> TENANT BUSINESS NAME 1, [i,orc <br /> ONTACT FOR PERMIT <br /> P mal <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: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project _New _Addition Remodel Repair T I. Sin Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK jadddiotlal spaceprondedon the bath) <br /> replace— <br /> epIllce gco <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New-_Addn AAlteratlon_Ropair Typo of Project. __Now_Addn _Alteration_Repan <br /> Show Number a)of Fixtures Show Numbers)of fixtures <br /> 'a C-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water healer Shower <br /> Gas hie lace Kitchen sink IL disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servlcelbarlmo lett <br /> I leaf pump Backflow preverdler <br /> Una heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor dram <br /> Woo stove Grease trap <br /> Duc-t i ng Roof drains <br /> Other___ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> Number of Heads Other <br /> I hereby cents that I have read and ermined Iles application and know the same to be We and correct At prowinps of laws and aremances governing this type )f work via be mmpl�ed <br /> with whether specified herein or nal The gronung of a perms adds not possums to give sumordy to wdlate or canal the provision of any other state or local law regulating construction <br /> Thal 1 am n/torted by the Amer or this property to pedafm the wart for wnfoh appacauun e,made and 1 cornph wnh the stale Contanars Law 18 27 RC W and 298 200A WAC <br /> Ow nd "ga ISlgnalure Dale I I (Revised 170 f]) <br /> rlnortre <br />