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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITIDN <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# P�21�IJf'� � � �� <br /> ��3i C�l� v2 c�o� �t���+oc���ac� � � 1 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> .—�-- /�, <br /> OWNER �,f I ��f!�� Phone/E-mail ^ (�� �Q'�'J - ��'l5% <br /> Address ��� City/State/Zip �(�.(�j`���,j, �jt�� ���(.�"� <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor�S A92f1t _T2f18�Y(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR � t> �"�{�L( �'1 , �i�1C.. State Lic.#J�� l�.�Tl� A' City Bus. Lic.# ' -�� <br /> � ` ���, <br /> Address ;3� ��� {r �� , ' ;F(, � �I�'�W;�;c� lU-� Phone/Email t7� ��� �� <br /> TENANT BUSINESS NAME C �ITACT FOR PERMIT <br /> �+' � T�`'� ���1 '�� -�t3�� <br /> Phonel�ad / <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ,�-�(�(�,� <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 /> T e of ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additiona�space provided on the back): � <br /> �' �� CL -20� �' <br /> �i-ey�Jf��� ��5 '�vrr���=c, ���-t.. �' ���1.�, . rl�o (_.�i,'�Y1z �;v�r �+ 5 � <br /> � � � <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 handiin units Toilet <br /> Forced air systems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater ' Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin 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 goveming this type of work will be comp, <br /> with whether specifi herei or'not.Th rantin of permit does not presume to give authoriry to viotate or cancel the provision of any other state or local law regulatlng construction <br /> Th am uthoriz y th owner of t s rop t erto �he work for which applicaiion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> � ,�-/��/��- <br /> wner/Authorized Agent Si ature Date (Revised 9/2014) <br />