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F <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 ADDRESS: PROPERTY TAX# PrK.,i#� _ ry <br /> LEGAL for new construction: Short Plat/subdivision -kW V``c Lot No.P2-3 (attach copy of long legal description) <br /> OWNER SI3 s Q PC 111,C,, jjl!\/1Q `1i(>, Phone/E-mail 44 25 (.1,5-..:a <br /> Address (�2D .StJ pli-e i *f V"V&l I \e 'l4"r'I VCity/State/Zip CV e f,--{ 't \j/Nip- q 42,0 <br /> APPLICANT:_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 � ,(nc ( /�'(�j^�j�),/�[ ��\{ (� AfY� State Lic.# /'T�VANI PLg( 7$, ity Bus. Lic.# O 2$ lk, <br /> Address(g22, e(GYEO l ' r 5�1+�(Yc 1-'; •SV1UV1(�I�(jl! w; Phone/Email L5too <br /> TENANT B, - ESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 1425 25 g O D <br /> N �� <br /> . <br /> BUILDING PERMIT APPLICATIO ` CONTRACT PRICE OF WORK ID L41/-7. OCL <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 /> 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): <br /> NEOC(- (q--- <br /> (I 1 USe r.e, P 60 re SS7 Nr),7) <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 air systems 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 /> Range hood Water heater <br /> Exhaust fan Sink(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: <br /> L 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 laws and ordinances governing this type of work will be compl <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 authorized� by the of this 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 /> ZG P/G % ^ /"1/7//i,� <br /> Owner/Authorized Agent Signatur‘ Date (Revised 9/2014) <br /> I•l <br />