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PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# <br /> Z P i <br /> Z :%� r.= — ,r ✓ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER r-a 'F _ LLCM Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent x1contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR -S7-V--\'J-1r'---V— - rzC COE Bus.Lic.#b <br /> Address lig��i.1:1&-.11Z•-. � ;�"`�(/ Phone/Email a�- �'�� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ♦si��ll L� G_—�� <br /> Phone/E-mail '°.� 5-1ZZ— r', 15VAIL-G tr1:1! �-i 4 F'06C "v1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK C� Ccs <br /> Existing Use of BuildingHEAT SOURCE: <br /> Proposed Use of Building Gas Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family.XCommercial <br /> Type of project: New _Addition Remodel Repair, T.I. Sign prinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> 1-46- rte N1eFrcrr�S I r�L S i�T•v ,-1 v� �•^� Zoo� ,z� I,�c r�d �. <br /> cr �5'� �. `� � �s Le.-�� i� S�-►PP�1' r1iJ��intr 'rvl <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—airhandling 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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ductinq Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> z�-X 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 /> 1 -C� -►14 <br /> OwnAu orized Agent Signature Date (Revised 612012) <br /> [Z <br />