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PERMIT APPLICATIC @ - <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# P RMIT# <br /> -� , ao - Dojodvdv <br /> LEGAL for new construction:�Short Plat/subdivision Lot No., (attach copyoflong legal description) <br /> OWNER ��/�G�// 1101�f/ �j sl�C�� Phone/E-mail �Z�U , Z Z'Z' <br /> Address?D ZQX City/State/Zp� j�C�j� � 0 <br /> APP LICANT:X Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a latter of consent from the owner to do worn In the space) <br /> CONTRACTOR NQ�� State Lic.# D�(!! C 1"1)(7)Z City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ,Q,,,/ / E-LTn✓E� <br /> Phone/E-mail 2S— J r61,f — <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 14450'5 <br /> 4450 , �D <br /> Existing Use of Building Jcie/�`iHEAT SOURCE: <br /> Proposed Use of Building 51� Gas_x Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type ofproject: New Addition XRemodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space,provided on the back): <br /> 4 iso _ cl <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 /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran a hood Water heater <br /> Exhaust fan Sink (service/bar/mop/­`etc.) <br /> Heat pump Backflow preventer inside bid <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refricieration Floor drain <br /> Woodstove Grease trap <br /> Ductinq 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 heraln 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 t e owner, f this property to perform the work forwhlch application Is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> Owner/Authorized Agent Signature Date <br /> (Revised 42015) <br />