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OPERMIT APPUCATI&A <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRiN LERDEMOLITION <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: r.l PROPERTY TAX# PERMIT# r 1 <br /> LEGAL for new construction: Short Plat/subdivision' Lot No. (attach copy of IIbngg legal description) <br /> OWNER ff'lf e I a t16i ^ill c� L Phone/E-mail C-� 6 v,�r JO CJ�/ C� v U 6 <br /> Address <br /> APPLICANT: Owner _Owner's Agent _Con <br /> tracto _Contractor's Agent _Tenant(must provide a leiter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAMFz CONTACMR PERMIT <br /> Dnv; 1�LO av�� <br /> PhonelE-mail U 1 v V I C-f IL ,i:-4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building Oft ( HEAT SOURCE: <br /> Proposed Use of Building t'' �ZGc u Gas_ Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: _New _Addition _Remodel _Repair.T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> {� ��►� .per �e ,n-trvs 1 <br /> P a r rW-d P IG—.s (� <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 Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater L 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 /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other; <br /> I hereby certify that I have read nd 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 specifie ere/ 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 lho' e by the ner of this property to perform the work for which�apipli tion is ade and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br /> v I I (Revised 4/2015) <br /> Owne thorized nt Signature Date <br />