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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 ADDRESS: 3 7 5 .0,1 cr PROPERTY TAX II PERMI 1 3 J vh© <br /> LEGAL for new construction, Short Piat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER i 11 AL l.►j eleti 1.-4>(it E Phone/E-mall <br /> Address 5 A 0,1%E' City/State/Zip <br /> APPLICANT: Owner Owner's Agent Aontractor Contractor's Agent _Tenant(mustprovidealetterofconsentfromtheownertodoworkInthespace) <br /> CONTRACTORr�A( 4 DI, 5/ ��, 5 7Zti 7 tr 'State Lia# (�n4, *1)C.I 0 7 7P City Bus.Llo.# <br /> Address l t{'i Si 4l�'r LS c 9' .t - ar"'/e- Phone/Email <br /> TENANT BUSINESS NAME Ai(9,1/ e. t.,4 qp?7 CONTACT FOR c4ivy.f <br /> PERMIT et , -.4.4r .J,,, <br /> Inc /") <br /> Phone/E-mall " et/AA- 99 elo44 iwi,�4 /4S <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Ls'' A440 <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_— Demolilion,„,-Change of Use <br /> DEESCRIPTIO0/91.vt#,C. <br /> OF WORK(addilional space provided on the back) <br /> 3-1a e--ec -®'-) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Adds Alteration Repair Typo of Project: New Addn ,Alteration Repair <br /> Show Number(II)of fixtures Show Number(N)of fixtures <br /> NC—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 i SUPPRESSION SYSTEM Other: <br /> 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 lave regulating construction <br /> That I am auth d by the owner• this property to perform the work for which application Is made end i comply with the State Contractors Law 114.27 RCW and 298,200A WAC, <br /> qiii <br /> v yr.yrl:Y- <br /> 0. =r/Aut orized Ag 1 -lgnature Date (Revised 3/2013) <br />