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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: 1305 I'V - STPf-F-T PROPERTAX#Z O O PERM T#` <br /> LEGAL for new construction: Short Plat/subdivision �Lot No. (attach copy of long legal description) <br /> OWNER M( Ca (,OCT D)f!L Phone/E-mail <br /> Address 32 2 City/State/Zip V [A/A 0Zab <br /> APPLICANT: Owner X Owner's Agent Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOROA4E State Lic.# ' ?g/!,( City Bus. Lic.# ��7 <br /> Address O, 2 (_ Phone/Email ZS - <br /> TENANT BUSINESS NAME CONTACT FOR PERMITAA)Lr-S WAL_KF)Zr <br /> POTFSCIVASd d- NA LL- AQC-�4 jfzt5. <br /> Phone/E-mail — — 6 Q a�C<7- Wt <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ODD <br /> Existing Use of Building �' HEAT SOURCE: <br /> Proposed Use of Building �- Gas Electric Other <br /> Building type: _Single Family X Duplex_Townhouse _Multi-Family —Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): K VTW � -f BAT,49X G1 >T FAYO PFL <br /> �U2-Cttf. <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 /> I Gas range Dishwasher <br /> Clothes dryer / Clothes washer <br /> I Range hood / Water heater <br /> L 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 /> 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 b the owneyOfn,,property t 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 Z0 <br /> O ner/Authorized iflrgeint SIgnature IDate (Revised 4/2015) <br />