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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 ADE IS. PROPERTY PERMIT <br /> C-6 I (%_PyA-vey- se ' 4e0 doIGV �IA <br /> 1 I b('d62., <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER gI. at, <br /> Vj ('�(/�1(t^C Kaf/ Phone/E-maillMe?— 7 �//`J c5 t O k(- J& ct"{ee, <br /> Address2- 0/ ( J2 Ave JEti a-44 14-33201 1-3R2tf/ City/State/Zip ,t/ thas( VA- 0220/ eGdi <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 ©`EA/kt,2R State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK %OM <br /> Existing Use of Building (2.0S td v14R-' ,? 14,4„-i-4-, 04 Otte) HEAT SOURCE: <br /> O f I (j 5 ? (4(4,1 4 j 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 F WqR additional spa e god on the back): Ite1 f\, sem p` 1. <br /> rgiec2N ygie4 cd. G�IA--(5 c 'af tCze sgc 1 -ice, / 5' ,--e- ,/,:eizi feces 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 Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units 2 Toilet <br /> Forced air systems Bathtub <br /> Gas piping Q_ l Lavatory(wash basin) <br /> Water heater I Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range 'shwasher <br /> Clothes dryer j CI es washer <br /> ange hood I Wate eater <br /> Z E 'aust fan I Sink(se a ice/bar/mop/etc.) <br /> Heat''ump Backflow p` venter <br /> Unit he. -r Urinal <br /> Boiler i Drinking Fountai N <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains N <br /> Other j Medical Gas �. <br /> SPRINKLER / SUPPRESSION STEM i Other: <br /> I 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 complied <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 owner 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 /> ClIC*e 0/ 7°0/26//2( '' 1 , <br /> Owner/Authorized Agent Signature Date (Revised 31204-3j'" <br />