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ERMIT APPLICATIO <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: �.. PROPERTY TAX#iP IT# <br /> t. ,�"'- �- ,�� �► opo -c�c� y o I S -O l -2- <br /> LEGAL <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ����S l`Qy\ Phone/E-mail <br /> Address �� ����� ` <br /> L �-- �� City/State/Zip <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 C­.,�� State Lic.# L`) City Bus. Lic.#0 x-19 t S� <br /> �\ K-,Lo \��M` ` \-� I�l �V�Lc,:,�j/\hi <br /> Address <br /> S S�'� V\-C� �� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas _ Electric Other <br /> r <br /> Building type: ,ingle Family _Duplex_ToWnhoi ice Multi-Family —Commercial <br /> Type ofproject: New Addition Remodel Ze p air_T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration12LRepair 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 /> 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 ce tha have read and exa 'ned this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be compl <br /> with wheth r sp ci ed herein or not.Th 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 a h 'z d by the owner of is 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 /> •/ .iliZA 4 An 4 n�fu�n nn4e /povicer!dM/11 FI <br />