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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 /> SITE ADDRESS: SL•�'��—L PROPERTY TAX# PERMIT# <br /> l �'<<,�� ���,- _� � �'w"J� =� �;�� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner Owner's Agent _Contractor _Contractor�S A92flt _TBflBflf(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR (�Vf}n �ij� State Lic.# City Bus. Lic. # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �-�r�' ,_/`' i.��,��;.;� J , ,., ._.__ _ <br /> , <br /> � ii' ✓�n Phone/E-mail `��`' � � � � � -',� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ='G{�� .C'L <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 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 /> /� � ` �' ,� ;--, �, <br /> /7��� GG �_�i, � XcS� ^' '�'_ �=•�c_ <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 /> i A/C-air handling units � Toilet <br /> Forced air systems I Bathtub <br /> ; Gas piping j Lavatory (wash basin) <br /> i Water heater j Shower <br /> ' Gas fireplace Kitchen sink&disposal <br /> i. Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> i 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 /> Ducting Roof drains <br /> j Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> � Number of Heads � Other: <br /> I hereby ceRify 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 pertorm the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 296.200A WAC. <br /> � � �_ <br /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />