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PERMIT APPLICATION <br /> BUILD ING/MEC HANICALIPLUMIBINGISIGNISPRINKLER/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: q 8 L D C PROPERTY TAX# PERMIT Q <br /> 300.3 LJ, CRS1Na Ra <br /> LEGAL for newconstruction: Short Plat/subdivision Lot No. (attach copy of tong legal description) <br /> OWNER p&S 11V(j C6e4 ttj"% Phone/E-mail <br /> Address \ C) Sox- 3-7 Or-T M S q`r- 09 r City/State/Zip S C--:A 78 1;2- "t� <br /> ! <br /> APPLICANT:—Owner _Owner's Agent X Contractor Contractor's Agent _Tenant(most Provide a tetter of consentfrom the owner to dowork in the space) <br /> CONTRACTOR (lVitrASITY MEeV,11V 1 t L State Lic.# 0A I V M e 3`13 N 1 City Bus.Lic.# <br /> Phone/Email —AddressLItG { ! <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �F (-��✓ARF�, <br /> &C"/t/C� Phone/E-mail sso- S'713 1 salvarez e-v-,ci•� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 8'f O to <br /> Existing Use of Building je�ANU V Oke-Tu HEAT SOURCE: <br /> Proposed Use of Building Nl,AN tJ F(ICT U({I N Cn Gas,—& Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Y_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 /> 7"'/4 of /oat^ 5+wk d+1c� vte�J emerge icy e�12e12sL. S^�2-,;at1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projoct: _,New_Addn _Alteration_Repair Type of Projoct: X 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 Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ranpe hood f Water heater <br /> Exhaust fanSink (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. EciAS V\ <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 latus and ordinances goveming this type of work will be comp <br /> with whether specified herein or not.The granting or 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 perfomn 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/Authorize gent ignature Date (Revised 912014) <br /> 7" <br />