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� � <br /> PERMIT APPLICATION <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 RESS: PROPERTY TAX# PE MIT# <br /> U � t.lJ ��'./� ✓��-- �p �j"L� Z� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER � �'l.� Phone/E-mail y =3''/�•—��"/� � <br /> � C� ���� <br /> Address �' � � � (,�� G �� �_� City/State/Zip i !'�. <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor�5 A9Bf1Y _T@l1811Y(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR � , ^�p�/ti • GC� State Lic.# U('L S - L� City Bus. Lic.# �{� �I�c <br /> = r <br /> a-� _ , , �_� <br /> Address Of7 � ;✓6c� �C� c� ,, �:� Phone/Emaily�j�y�-O`'��' 1 �..C�� Q�•YJ�C'J ��:�« j. r�'`�-- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �`�e� <br /> �/�,, � (�c�'i <br /> � �1 �'-t61. • ��� � <br /> Phone/E-mail ,� ��}'�b_p�j'7� ��-'�JyG'1/,nG� ��-'�.��y. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ��)OC�• �� L� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric_ Other <br /> Building type: _Single Family �Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro�ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESC�RIPTION OF WOR�C(additional space provided on the back): � <br /> ,��,�� f�t1e�.�; ; '�./_ ��,y l . �,-� ��'U�- �3 �!' �'.,5��_,��f> �.��.� E��, �c�a � i36� <br /> ��c c.��e�'�- .�G� )e.l �'�c�.�11� � � ��--� r�t�'•�.-v J -c � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Num6er(#)of fixtures Show Number(#)of fxtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> ,5 Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink 8�dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> � Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> � Woodstove � Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUP ESSION SYSTEM � Other: <br /> Number of Heads Other: <br /> I hereby ceRify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances goveming this rype of work will be compl <br /> with whether specifed herein or not.The granting of a permil does not presume to give authority to violale or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of thi 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 /> �-a��- 5 <br /> w e Authori gent ' nature Date (Revised 9/2014) <br />