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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# P R�T# <br /> iegpo erlly �vE tr+ -® l <br /> LEGAL for new construction: Short Plat/subdivision�:+V r&t '1D-to Lot N6!t 4(attach copy of long legal description) <br /> OWNER ! L c G.V Phone/E-mail 4Zs--- -3 <br /> Address Z{'O Lot). I 15(Pd' City/State/Zip eve WA 't,2 Z3 <br /> APPLICANT:i.Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Sift Qrt .�'C State Lic.# City Bus.Lic.#04(02y i 4 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Co.ktmc C-14.491)* $ai e S Sc-kr-t-E "2bs"b <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK e712900 <br /> Existing Use of Building Mr„� ' �' HEAT SOURCE: <br /> Proposed Use of Building /464 K.Se. 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 /> t 141 Sr '('ens twcf400'ue-^1- 1,1"J .6 c1511 I)1143 <br /> fait- v•tkv-eitl' <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 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(inside bldg) <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/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 comp <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 t O d b he •f this property to perform the work for which pplication is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 67 <br /> Owne ' hied Agent Signature Date (Revised 4/2015) d <br /> _moi <br />