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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# C"n <br /> 17k:) uf\y- 5 c ooy 50 (.fib --0o <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address 7,13 City/State/Zip e-v <br /> APPLICANT: Owner _Owner's Agent �,Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner ,to do w in th space) <br /> CONTRACTOR ?- VS L&I LicVPh.ne/Email <br /> �' DO COE B/us. Lic. P157-4 <br /> Address10%W M�V,V -,�e-:3 /I •1�(p� <br /> TENANT BUSINESS NAME W V1-J -ptLj CONTACT FOR PE IT � <br /> �rlrE�l ENDv�'¢-T'tu9 •Capt <br /> C Phone/E-mail ?i C <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building EAT SOU <br /> Proposed Use of Building F- Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family X 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 /> IN 1�� 'riol� OF E:MP tLP SI(7kP)C:7 E. <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 <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 authorized by the own is p perty to perfo the work for which appli ation is m de and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Ver/Authorized Agent Signature Date (Revised 6/2012) l <br />