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"PERMIT APPLICATION <br /> -UILDING/ ECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> BS <br /> 200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# # <br /> 320 5/h ,.nt sr J 6-1/brii MA"MA" 5 iRM o —co; <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWN ER Phone/E-mail <br /> Address 3225 ( ikkj ev6,Qe- zipy_ City/State/Zip i / � 9 ze <br /> ,APPLICANT:il.Owner _Owner's Agent Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR r 6 p State Lic.# City Bus. Lic.#®543/1 6, <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT G,oi,a_q gip <br /> 6//t /Z7 j/ C,v Phone/E-mailii2S-Z57 //,S�/ 1,4 J+r/4'tP2'/j4ta, 9lJ i <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK q, /00 <br /> Existing Use of Building / " ee/Y o HEAT SOURCE: <br /> Proposed Use of Building '-7 1211-715/7 Cf/1 AL 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): m4044. it / p2/rZ) . <br /> &w t'— GJ'p1L /y/1i.e 1./be-,e74- mil- ,1e-rA) iceer /49 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration Repair a of Project: _New jddn _Alteratio _Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units Toilet <br /> Forced air systems 411 Bathtub <br /> Gas piping Lavatory(w h basin) <br /> Water heaterShower <br /> Gas fireplace Itchen ink&disposal <br /> Gas range 1/'-- sher <br /> Clothes dryer Cl washer <br /> Range hood ater h er <br /> Exhaust fan Sink(servic ar/mop/etc.) <br /> Heat pump Backflow preven r (inside bldg) <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: <br /> Number of Heads Other: <br /> I hereby certi hat 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 comp <br /> with wheth pecified herein.r ot.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 a thorized by th- . er of this p`.erty 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 /> , , q. 0—IS 42- <br /> Owner/ thorized Agent Sig ature Date (Revised 4/2Q15) <br />