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• • <br /> PERMIT APPLICATION <br /> BUILDIN /MECHANIC?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 DRESS: PROPERTY TAX II R <br /> P MIT# <br /> c`167)0{) 7- 20/1641 4,3Y ) ikA i . )(—'-- (W4 <br /> LEGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) <br /> OWNER1'r (fie ,/2-,7 Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner Owner's Agent Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do word in the;pace) <br /> CONTRACTOR / 7 I), 'Vic <br /> ° /flee f .Jh; State Lic.# /14:Vm /X„„: y' ,Mi43,us. Lic.(g�5706- <br /> Address 1f/ 4 kg 441 c.. ta d 9265:,Phone/Emiilrf..5%-.22 Z - 7:',$ <br /> TENANT BUSINESS NAME J CONTACT FOR PERMIT .fie •75'0-`7,P 8, <br /> 7.)/ Phone/E-mail t4?(„) 7 d -1( tJ< (;t '1 f 1j fIC �? a��y "s <br /> BUILDING ERMIT APPLICATION CONTRACT PRICE OF WORK r /3,i ) J e&1V <br /> Existing Use of Building 2{ •-,. (— HEAT SOURCE: <br /> Proposed Use of Building C) f:::F7 C_ "- Gas `, ` Electric„ „ Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family 44 Commercial <br /> Type of project: . New Addition C Remodel _Repair T.I. Sign__Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> RE 1C'e4-if C)IT/E../°' , li-b1)CI j 5 1,4 14" (i MO tie(10 6 1 1-ril4t5 <br /> *MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATIO <br /> Type of Project: _New_Addn _Alteration Repair Type Project: _New_Addn _Alteration Repai• <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> i A/C—air handling units i Toilet <br /> Forced air systems \ I Bathtub <br /> Gas piping ",.7i Lavatory(wash ba 'n) <br /> Water heater -� Shower <br /> Gas fireplace ( I ' Kitchen sink disposal <br /> Gas range I Dis.hwashe <br /> Clothes dryer I Cloth: asher <br /> _ I Range hood I Wate heater <br /> I Exhaust fan I Si, (service/bar/mop/etc,) <br /> Heat pump ! Backflow preventer <br /> Unit heater I Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove I Grease trap '-‘,... <br /> Ducting Roof drains <br /> /) 1 Otherly J L ?f46.rj.6iC6 ; Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I Other: <br /> Number of Heads i 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 laws and ordinances governing this type of work will be comp) <br /> with whether specified herein or 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 am auif)d inert by the owner of this properly to perform the work for which application Is made and I comply with the State Contractors Law 18 27 RCW and 295.200A WAC. <br /> l• <br /> V):,,,,..- <br /> Owner/At thorized Vent Sig ni(ure Date (Revised 9/2014) IZ" <br />