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PERMIT APPUCAflON <br /> BUdDING/ ECM NICAL/yaUMBINGSiON/SPRIN / ER/®EMOLITIN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereftwa.org <br /> SITE ADDRES PROPERTYTAX# P M T# <br /> /op 0'/q2=577 0 <br /> LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal description) <br /> OWNER AQA16 sl 0 G l.LL Phone/E-mail L1715'- 2721 -0141 <br /> Address V Li)C(G tG city/State/zip .(fV' fT /E Zp <br /> APPLICANT:—Owner —Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter ofc❑nsent from the owner to Up work In the space) <br /> _ - City Rus. Lic.# �(r1`1 5CONTRACTOR �&a - State L'c,# �_V �S <br /> Z; �"j 11 t/Address 21�D AUC. �-evrLO <br /> TENANT BUSINESS FIAME CONT ACT FOR PERMIT <br /> mmG @ wA .e4 At <br /> 0,�„-Xnr Phone/E-mail Z- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK A*70 O <br /> Existing Use of Building ND L'/�l�J✓Gd' HEAT SOURCE: <br /> Proposed Use of Building /�O G6e Gas_ Electrics 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 /> RE,fAW 6 CZrp(acc C IUSTI P& 20 f4L,) S(e(,4rtC <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration X 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 /> NLESPWater 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 /> RIINiK(il -IR <br /> Ducting Roof drainsOther Medical Gas <br /> / SUPPR(ESSIOM 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 /> wish 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 /> �Ow��uthAgentSignature Date (Revised 412015) <br />