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OERMIT APPLICATI010 <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> LEGAL for new construction. Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner _Owner's Agent Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# G 0 3 52 5' 7 419ity Bus. Lic.# iv <br /> Address 10? 2i6 S el, ShO40.4-_Z�q t,,64 Phone/Email Y- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail nrte4D <br /> BUILDING PERMIT A,,P/IPLICATION/ CONTRACT PRICE OF WORK 10 -5 O0 <br /> Existing Use of Building /ti'�eAiL+�+ L3�;�d�/�,, HEAT SOURCE: <br /> Proposed Use of Building Air ,`Gg( �� li> / 7 Gas Electric Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family Commercial <br /> Type ofproject: New Addition Remodel Re air K T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION <br /> //OF WORK(additional space provided on the back): p / <br /> Rovg4 i'i b/leve,(tJeA�IL u'-sl, f- W,,� 1', 0- / 9"nj`rIDM �"/! �j �.. l 2-a)IfISAN/mss <br /> MECHANICAL PERMIT APPLICATION 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 I Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water 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 <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: 14u (3 c..° <br /> tj <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 W 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 amad#p�orized y th ner 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 /> t sae°ao<.+oi)n4et <br /> t0,5 . 0 � <br />