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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/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# P lT <br /> t rn Zc)cay� 1')�80g0 la©H0 2. o 3 <br /> LEGAL for new construction: Short <br /> Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �f�nQ �, 4fby! �ei-SaA Phone/E-mail 'L-06 -Si% (opt, z,y <br /> Address ^ -l�� ?,3?� to Z � ,�� tiles City/State/Zip Irl In .�, � C p Z, <br /> APPLICANT:_Owner —Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a tetter of consent from the ownerto do work in the space) <br /> CONTRACTOR &-C-V%\1e a pore S QStatte 7Lic.# 4306C 13ToI AD Z City Bus. Lic.# 05. 3%7 <br /> Address _39 Z 2 -i+b P� NE A xx sU t 1e l�f G..'i 01 Phone/Email`1Z..5`2-q0'-2:,4 2 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> t-t•tt CL c <br /> Phone/E-mail �%�' <br /> Ir�uctck bit; h��S ,c '0 y'-1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building_ Gas_ Electric_ Other_ <br /> Building type: J Single Family Duplex Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 airs stems Bathtub <br /> Gas2iping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes <br /> dryer Clothes washer <br /> Ran a hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat um Backflow preventer <br /> Unit heater Urinal <br /> Boiler <br /> Drinking Fountain <br /> Refri eration Floor drain <br /> i Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> I <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be We and correct.All provisions of laws and ordinances governing this type of work vnll be comp) <br /> with whether specified herein or not.Th granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local taw regulating construction <br /> That I am authorized by the ow er of thi roperty 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 /> Ow r/A thorized Agent S19hature Date (Revised 9/2014) <br /> i <br />