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PERMIT APPL,ICATIL1 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 9821 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> 1 & 1cj C , � <br /> SITE ADDRESS: PROPERTY TAX# P MIT# i DQ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER / Phone/E-mail <br /> Address y A,-I"-11 ;�--,--e7t.,, City/State/zip 5 fid l e7,� w ?52 C <br /> APPLICANT: Owner _Owner's Agent �&Contractor —Contractor's Agent _Tenant(must provide a letter of <br /> consent from the owner to dp work In the space) <br /> CONTRACTOR S'�'c� < {'1 State Lic.# IfrS L L (� City Bus. Lic.# <br /> l Phone/Email z n <br /> Address S/ / �� '�L 't -51- S'/7G �c«��5� 't <br /> CONTACT FOR PERMIT <br /> 5-7f- Ae 16(/ Phone/E-mail '/:Z S' ' s TiG/�— _& <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK / 3'SG• e-.T <br /> Existing Use of Building Cc-�� c �,� HEAT SOURCE: <br /> Proposed Use of Building C /��� e Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family —Z-6ommercial <br /> Type of project: _New _Addition —Remodel _Repair_T.I. &ign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): / <br /> 5'i Gj <br /> c;iec be47'411'a" <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 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 /> That I am orized by the owner of this property to perform the work for which <br /> application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authori d Agent Date (Revised 4/2015) <br /> rV-0 <br />