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i <br /> PERMIT APPLICATION <br /> BUILD1 NG/MECHANICAL/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: Th PROPERTY TAX# OO,a bll P IT# <br /> 290 a�N- <br /> L4 nw <br /> LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal descr' tion) <br /> OWNER S Phone/E-mailLZ- 3 3 gswan s4ovw cks,coe, <br /> Address Z—LLI City/State/Zip rSE.A L-- U0134 <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 L&I Lic.# COE Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 2,0 . &0 D'p 'L� ukkf <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building r-aS;AUf?,AdT '%- Re-x t - S A L-� HEAT SOURCE: <br /> Proposed Use of Building go c ft4( — S A MIS A'S a.x(s?-I►4q Gas ✓ Electric_ Other_ <br /> Building type: _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(additional space provided on the back): <br /> 1+ ►� Int ��c�t D0Mou u.Pdittnj vvl[s,fty►;tore, atstwo - <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 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 lothes washer <br /> nge hoodter heater <br /> EL-ftaust fan Sink ervice/bar/mop/etc.) <br /> Heat p p Backfl0oQreventer <br /> Unit heat Urinal <br /> Boiler Drinking Founta <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> 3 Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTE 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 /> 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 /> 3 ZS <br /> w er/Authorized Agent Signa re Date (Revised 6/2012)_y <br /> /� _ <br />