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PERMIT APPLICATION <br /> BUILDING/MEC HANICAL/PLUMBING/SIGN/SPRIN KLER/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 AD ESS: o, PROPERTY TAX# <br /> +L. Ci. ri <br /> LEGAL for new construction: Short Plat/subdivision ATTP<—VceO Lot No. (attach copy of long legal description) <br /> OWNER .f Phone/E-mail <br /> Address 'j( 'F(* 2� �—i�E City/State/Zip E�� �� A-- m2pa O� <br /> APPLICANT:X Owner Owner's/A��gent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ��bi f State Lic.# City Bus. Lic.# <br /> Address I Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �Y�N�I� rV 2$12 A0..'-Ort TVEiC (j <br /> O(� Phone/E-mail L 2-52-zt <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR '— <br /> Existing Use of Building EVJaP0T1c^4 HEAT SOURCE: <br /> Proposed Use of Building SAME Gas_y Electric Other <br /> or <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): PeEV kc)Vej - V­yu5-TINL6 <br /> Coo IS i E�.;t (, ^ A Ls i> <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn X, <br /> 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 airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat pump Backflow preventer inside bldg) <br /> Unit heater NG <br /> Boiler Fountain <br /> Refrigeration in <br /> Woodstove ra <br /> Ducting Roof drat <br /> Other Medical Ga <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 comp <br /> with whether specified herein or no Th 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 a thorized by the ow r o hrpe ty to pert work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 7 <br /> wne A orized Agent Signature Date (Revised 4/2015) <br />