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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 /> SI E ADDTS: lky_ TAX#1 C) Z) <br /> 41 D`1I`— InT, +­t�j omo/, I <br /> LEGAL for new construction: Short Plat/subdivision ........... (attach copy of long legal description) <br /> OWNER C-2 cc Phone/E-mail 1:;?, D <br /> Address Q-�� I City/StatelZip <br /> APPLICANT:—Owner _Owner's Agent _ <br /> Contractor _Contractor's Agent Tenant{must provide ate!�tcfto4,zoiser�tt.O�.t".�-1lloc!o,..2,k,nt�le�,(MCO) <br /> CONTRACTOR IState Lic. # Jk4-qqJ eq City Bus. Lic.A C) C) <br /> Address q 01 lef I �"e lPhone/Email -09 q 19 - —3A ob <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT_J a rn I t <br /> 00 <br /> I A-0 CA <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 9 <br /> Existing Use of Building if> HEAT SOURCE: <br /> Proposed Use of Bu ldjctg Gas Electric Other <br /> Building type: _Single Family Duplex_Townhouse —Multi-Family —Commercial <br /> Type of project: New Addition Remodel Repair - 'I Sign Sprinkler Demolition Change of Use <br /> DESnC�IPT19Nl \ OF WORK(additiomlislaProvided on the back): <br /> lue, <br /> ) � as bz� ", 6- ( .I <br /> -,a- -- <br /> qV— <br /> C) clt- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Aller.tion—Repair Type of Project: _New—Addn ---A11.,.fion—Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C--air handling units Toile', <br /> Forced airs stems Bathtub <br /> uz-k-U,ti 3-1 Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fircplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(servicelbarlmopletc.) <br /> Heat pump Backflow preverter <br /> Unit heater I Urinal <br /> Boiler Drinkinu Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Othor-- Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other! <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined INS application and know the Sarno to be true and correct.All provisions of laws and ordinances governirg this type of:work will be comp <br /> h whether 5peciried herein or not.The granting of a permit does no!presume to give authority to violate or ranCOI the provision Of any Other state or local(aw regulating corstruchan <br /> Tha tam authorizedb if' fit s party to perform the wotk for`vh'chfappllcalln Is made and I corr.ply with the State Contractors Law 18,27 RCW and 296.200A WAC. <br /> ,tr/Autt�,mm,d Agent Signature Date' (Revised 9/2014, <br />