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PERMIT APPUCATION <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.evereftwa.org <br /> SITE ADDRESS: PROPERTY TAX# P 131 <br /> IT# <br /> LEGAL,for new construction: Short Platisubdivision Lot No. (attach copy of lung legal description) <br /> OWNER U, 1U t41-41C72-L. Y Phone/E-mail <br /> Address a >� City/State/Zip <br /> APPLICANT:—Owner _Owner's Agent Contractor —contractor's Agent _Tenant(must provide a(eller of consent from the owner to dp work In the space) <br /> CONTRACTOR ;��� - ��t� &M4� State Lic.# �-VE-495 092-f t City Bus. Lic.# Oo"?155 <br /> Address 2120 C AUA2,n—[ U�t l� ��Vim.-©( Phone/Email 42-"--) <br /> CONTACT FOR PERMIT <br /> v Phone/E-mail Z52-3/PV <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 15,W6 <br /> Existing Use of Building DcAle)6 HEAT SOURCE: <br /> Proposed Use of Building &," ABY Gas Electric Other <br /> Building type: _Single Family )C. Duplex_Townhouse _Multi-Family ^Commercial <br /> Type of project: _New _Addition 5( Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WOR�(additional space provided on the back): <br /> A 05'N'b t-fr-1 T l a ekPl 0�1101116 s; 12t'ptf-kI / 7- 1,!j� lAr U/447,- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn ,_Alteration4Repair <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 /> i' Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> 1 hereby certifythat 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 /> pr/Authoriz ent tgnature Date (Revised 4/2015) <br />