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*, 0 1 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SP RINKLER/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 da— <br /> SITE ADDRESS: PROPERTY TAX# P9 lm�l <br /> T# <br /> LEGAL for new construction: Short Plat/subdivision�d��VI�1.ri�I�.�.31DLot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address 3 F< 3il City/State/Zip ( A <br /> APPLICANT:_Owner Owner's Agent Contractor ,,Contractor's Agent Tenant(must provide a leiter of consent from the owner to do work in the space) <br /> CONTRACTOR XRE<k <br /> tFAn&3, C-%,, I L&I Lic.# COE Bus. Lic.# ' <br /> Address W-33 V).60-,r Jt Phone/Email Y §ft— 1901 <br /> TENANT BUSINESS NAME CONTACT FOR PERMITT� <br /> Phone/E-mail 'Z -9l3 ��✓ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Building type: _Single Fam ly plex_Townhous Multi-Family —Commercial <br /> Type of project: New A Ion Remodel Repair T.I. Sign_Sprinkler Demolition_Change of Use <br /> (DESCRIPTION OF WORK(additional space provided on the back): <br /> (roque i SDC- u3(, IJF..J JrE-WtIFf_ y FULL- Vim• p�V-*A) <br /> Fqi is o <br /> MECHANICAL PERMIT APPLICA ION 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 /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> I Water heater Shower <br /> Gas fireplace Kitchen sink&di sal <br /> Gas range Dishwasher <br /> Clothes 5por ClothesWasher <br /> Rang ood W r heater <br /> ExKaust fan ink(service/bar/mop/etc.) <br /> eat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> 7-1 Refrigeration All, Floor drain <br /> Woodstove I 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 /> *amthorized <br /> rein 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 /> h0own f 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 /> ature EFate (Revised 6/2012) <br />