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PERMIT APPLICATION <br /> BUILDING/MEC HANICAL/PLUMBING/SIGN/SPRIN KLER/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# PERMIT# <br /> iowi ,,Sa 0 e-+e A ;�;Dj d <br /> LEGAL for new construction: Short Plat/subdivision A,\li�IAC a,Y At g Lot No. (attach copy of long legal description) <br /> OWNER c�oo� G ,Jk,nA �Cr��l' i,(r hone/E-mail q?-9- <br /> Address PO 3 City/State/Zip 1\e`/J C 9 g 00 l <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 J p cNn. I State Lic.#C C PO U S QpCity Bus. Lic.# q 7 70 <br /> Address NCO �1$ A,reS i'�, C�/ve- WA C( 005 Phone/Email qas --y-, \000 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> `c <br /> ��� [�JS:v.cJ 1 Se­� Phone/E-mail 4425-7 qC. 1000 r`ip r�0J7 k4ee,C.p <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building f HEAT SOURCE: <br /> Proposed Use of Building '►�\ Mc,t\S t C, -J J i'-�Ah, Gas Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family __%,/ Commercial <br /> Type of ro ect: ✓New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1---(c:"T r 'c"�1�-G t T*/L--I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: -.^ew_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 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 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 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 /> 'Z-/L / Is <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br /> Ill <br />