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PERMIT e4PPLIC�4TION <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 AD E S: �� •I PROPERTY TAX f� P RMIT <br /> '�o��� � �s��� �v �v�r �6 � — o� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �b����7 Phone/E-mail <br /> Address i'0 f`�6�C 3�1�1 ly I S U ��4�'�� City/State/Zip 5��,/i'i'�L"�,, Wfl �12,�9'-z�,Q`7 <br /> APPLICANT:�Owner _Owner's Agent _Contractor _Contractor�5 Ag@�t _T8f12f1t(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 6(�i�j� " State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �� ��►�t�t, 9a5-�$-0��� <br /> Phone/E-mail '}� , �� � � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .� ���v:�� <br /> Existing Use of Building ��G HEAT SOURCE <br /> Proposed Use of Building M F� 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): ,n � <br /> �7 u. � <br /> �-+t�s�� �,3� S�C��T7Ui�� Of= f,?��Lt�� 1"�C,lt �� T�= �a-��i-� l j�-T�'LC�/r�,�;-�"� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Aiteration_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 /> i 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 i Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting � Roof drains <br /> 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 ta 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 pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> `(� <br /> /��a ��S <br /> Own �/Auth ri ed Agent Sig re Date � <br /> (Revised 3/2013) � <br />