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PERMIT APPLQC lI I , q <br /> BUIL.DINGIMECHANCAL/PLUMBING/SIGN/SPRINKLE.I MEMOLI` ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> LA PROPERTY TAX# <br /> TF <br /> MIT# <br /> SITE ADDRESS: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> 11 <br /> Phone/E-mail -6kS . G C>s'✓I <br /> OWNERC.`1t^tSTp` �� -l1 <br /> AddreS4&)oI j I4 V �.. ,4 j wv City/State/zip v�o,-z° <br /> LA 7_G/ <br /> APPLICANT: Owner —Owner's Agent _Contractor _Contractor's Agent —Ten a Fit(must provide a leiter of consent from the owner to dp work In the space) <br /> CONTRACTOR ) i' State Lic,# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT 13USINE-SS NAME CONTACT FOR PERMITL�y t ��,f u <br /> -,�o6-679 —(v/2S <br /> Phone/E-mail ax, ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building Sp HEAT SOURCE: <br /> Proposed Use of Building S r� Gas_ Electric other <br /> Building type: >C-Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: _New _Addition Remodel —Repair—T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(addbonal space provided on the back): I- n w <br /> Tr-Je v'i o," A J f e lr,'Aq�d�,- o f s Ian)l2 ��^r`t/ b y rr� <br /> U §eY`(Ak <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 ex Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range P 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 /> 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 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 /> Thatill 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 16.27 RCW and 296.200A WAC. <br /> L - / �; <br /> Owner/Aut orized Agent Signature Date (Revised 4/2015) <br />