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• <br /> IkERMIT APPLICATI <br /> BUILDING/MECHANICAL/PLUIVMBING/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 ADD- SSS /' - PROPERTY TAX#_, PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No.3 oZ (attach copy of long legal description) <br /> • <br /> OWNER A\- 3.Q ?34)\ n �,b1�. Phone/E-mail. y2,5-- ././z)2417.� 3q. � _ lh,, a, u 6;``e � <br /> '. . '1 <br /> Address )za ( re:\4>1- of,\ City/State/Zip rad�1 \ ) (SOA ? 7 <br /> APPLICANT:)<Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR OL)Jai,-- State Lic.# City Bus. Lic.# • <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT - 2 • <br /> 5' - ^ `l <br /> Phone/E-mail k k `\-,01--)t t 1 c ni✓% • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK W 13o,oOo.('=- <br /> Existing Use of Building HEAT SOURCE: <br /> • <br /> Proposed Use of Building D d p X. 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 /> V u\ X, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: J ew_Addn Alteration_Repair Type of Project:New Addn Alteration,_Repair <br /> Show Number(#)of fixtures Sho Number(#)of fixtures <br /> NC-air handling units ... - Toilet • <br /> Forced air systems --?_____ Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater I Shower <br /> Gas fireplace 2, 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> I Other Medical Gas <br /> SPRINKLER /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 law regulating construction <br /> That I am aut orized 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 /> C1/4) <br /> 604 <br /> Owner/A hdtize Agent g ature Date (Revised 4/2015) <br /> (iT ) <br />