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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: PROPERTY TAX# PERMIT#C'� ! O`J I <br /> 7 <br /> LEGAL for new construction: Short PlaUsubdivision _Lot No. (attach copy of long legal description) <br /> OWNER j�Yf �C. LL�i ��E�a� �3 ,t� ��%!')Q✓�c.h(Iyi'IfeJ Cd�rn <br /> Address� g 7C( ��E �Q5 City/State/Zip � �� /� � �7C/ <br /> APPLICANT:�wner _Owner's Agent _Contractor _Contractor'S Ag@flt _T@fl2flt(must provide a letter of consent from the owner to do work in the spacej <br /> CONTRACTOR ��iC. l..�--C� State Lic.# I�l'��. � 77�� City Bus. Lic.# �7� <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT DD✓ <br /> D�3��/3y.� <br /> Phone/E-mail ��mz� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF K�i I Z� <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 Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ��� h�'� b��'c �3�� � ���� � <br /> �,����s� �««t�� <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 handlin units '-� Toilet <br /> Forced air s stems Bathtub <br /> Gas pi in Lavato wash basin <br /> Water heater a Shower <br /> Gas fire lace I Kitchen sink&dis osal <br /> ( Gas ran e � Dishwasher <br /> � Clothes dryer � � Clothes washer <br /> � Ran e hood Water heater <br /> Exhaust fan I Sink service/bar/mop/etc. <br /> Heat ump I Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> � ' Refri eration Floor drain <br /> � Woodstove Grease tra <br /> Ductin y 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 corzect.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or noL The granting of a permit does not presume to give authority to violale or cancel the provision of any other state or local law regulating construction <br /> That I am aut rized 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 296200A WAC. <br /> �-�a� <br /> OwnerlAut or' ed Agent Signature Date (Revised 9/2014) <br />