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( IMnnEAe-(1kt- <br /> I <br /> '*PEIIT APPLICATIA C MvALM pe-ill"t 1.,0-e-649 <br /> BUILDING/MECHANICAL/PI UMBING/TIN/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: ^ PROPERIYTAX# PE IT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER tH - D !f hone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner —Owner's AgeW_Contractor —Contractors AgentTenant(must provide a letter of consent from the owner to cip work In the space) <br /> CONTRACTOR � State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSIRESS"WAME CONTACT FOR PERMIT <br /> �i6WtWo- tC 616,0 U.414 �� ��� Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building E'er ,r HEAT SOURCE: <br /> Proposed Use of Building ty/!y1 S Gas_ Electric____ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: —New _Addition _Remodel _Repair—T.1._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> _ EIC c S 14 N6 <<t?Wvj <br /> 5'e E t7gvt ftry"ev7 <br /> L,t S 7 &A- Nkt-t.► (.4 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ _-Alteration 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 �issherClothes dryer washerRange hood heater <br /> Exhaust fan Sink(service/bar/mop/etc.)2-Piv r <br /> Heat pump Backflow preventer(inside bldg) <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: t C1I <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 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 /> *OWI/ <br /> horized Agent Signature Date (Revised 4/2015) <br />