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• • <br /> 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 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: , PROPERTY TAX# PM T <br /> �c\k ✓- (, t e <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER (Ct f r J r tT Phone/E-mail -�ZS 2-c9S-• Z)2 Z.7 <br /> Address I �j I Z %C '"�.r� Y ✓� ,''~ y 7 .�':;I/"/Ir State/Zip r'--�n �//.1✓��{e` / Wo 7 <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 State Lic.# _ City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT / _r <br /> Phone/E-mail -2-5*-Z JS .92-7- f� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ,9 J: <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse yfMulti-Family _Commercial <br /> Type of project: New Addition Remodel V Re air T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OFORK(additional space provided on the back); <br /> t-1 v, iIlk �t�1<k �Itr yC, /C�ro��G( <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 SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that 1 have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances goveming 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 o rwr 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 /> _? <br /> Owner/Authorise Agent i nature Date (Revised 9/2014) <br />