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BUILDING/MECHA�\ICALIPLUMBINGISIGNISPRINKLER/DEMOLoTIO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 08201 425-257-8810 FAX 425-257-8857 www.evereftwa.org <br /> ITE ADDRESS- PROPERTYTAX# I <br /> L ` <br /> LEGAL for new constrUc n: Short Plat/sub++division Lot No. IJ (attach copy of lung legal description) <br /> OWNER CNA VLJr, Phone/E mail Z7- Z jSd 2 l <br /> Address 2(27 Co �j t b City/State/Zip WA, 2-01 <br /> APPLICANT: Owner _Owner's Agent _.Contractor _Contractor's Agent Tenant(mus(provida a letter ofconsenl from the owner to tip wodc In the space) <br /> CONTRACTOR ':-:5TPc-f6- Zj Zr1U`(1'-K— State LIr,,# City Sus. Lic.# 0o`119 <br /> Address �t`�it�j f iF� G �1; - , I.1A q o¢n.,fJ( Phone/Email 4 Z'� 2-!s-2 (� <br /> TENANT B0s1ffff95-WAVM CONTACT FOR PERMIT <br /> qq -4,K"-64 Sd�W A i'wc <br /> �1, LSU up"` /a`jSC>Li Phone/E-mail 25- 2'j 2-3i1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK / 060 <br /> Existing Use of Building (`(© ��lt7t•l�' HEAT SOURCE: <br /> Proposed Use of Building H 0 0t 4-%oGt' Gas_ Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: _New_Addition _Remodel t- Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICA`i'ION PLUMBING PERMIT APPLICATION <br /> Type of Project: —New_Addn _Alteration_A_Repair Type of Project: _,New—Addn <br /> _--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 Lavafory(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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> j Ducting Roof drains <br /> Other Medical Gas <br /> SPRiNKLIER / SUPPRiESS90M 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 /> 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 /> �voneslAutho ' e g gnature Date (Revised 4/24 <br />