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4PERMIT 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# T <br /> (cC 7 CVe r-64 7a 11 t� -# K 4 2�� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NW -?no-0- Rm v-heS I if) Phone/E-mail ^ <br /> Address I Z,11 © NE �7� � City/State/Zip vvco6 rlvi i1� i A W %01(. <br /> APPLICANT:_Owner Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the o do work in the space <br /> CONTRACTOR V State Lic.# f395jSJS* 0J7C City . Lic.# <br /> Address Phone/Email 125.ZO,eIbO C <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> S� �3��s �In►�l� /� t,, <br /> Phone/E-mail `�o7.S 37J[f,���a biDt51.,9A @ mSn•(p <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 'f(Za30 <br /> Existing Use of Building oil mt(p)CC L a HEAT SOURCE: <br /> Proposed Use of Building `a lylk- Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family XCommercial <br /> Type ofproject: New Addition Remodel _Repair T.I. i n Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1v�SficrI1 (a) LED C\35WIA S14bn A%SpIa.9s <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 airs stems 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 <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 SYSTEMOt e h r: <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 i roperty 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 <br /> l-7 <br /> 116 cH <br /> caner/ horized Agen ign re Date (Revised 9/2014) 2 <br />