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t <br /> 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 MIT# <br /> //i/O0 � ' ve f- re (d y 5 f$p5�D� <br /> LEGAL for new construction:/ Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ��/{.� Sc Oaf, „�07- <br /> 4, Phone/E-mail 1/71 .20q-25z Ai <br /> Address b gox 86,0City/State/Zip p&rt. t nv,'/ , ,¢e„ 72.7 VT- <br /> APPLICANT: <br /> 'ZAPPLICANT: Owner _Owner's Agent / Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the o to do work in the space) <br /> CONTRACTOR RGtwnSaY slows State Lic.# t, &.Ji 636,e(...) City Bus. 'c.# <br /> Address atm " --Nth tile, 414444'/'a' / Zee Phone/Email„03.77.7., 45 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> LI. 41"1 Ar,"1 Phone/E-mail 5.::›.3-7 77 n itssserd e6 ");„A o, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK F` 0P *4 <br /> Existing Use of Building r1, "/- HEAT SOURCE: <br /> Proposed Use of Building{ M4„,41'y Gas Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New _Addition ^Remodel _Repair T.I. )C Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> -7-:::4"-‘7&// 14 60 i �. crag Asa me +* �f�� ��,� - <br /> 1. ?f-e „i -J uv1- tN iv i <br /> MECHANICAL PERMIT APPLICATION I 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 <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 of local law regulating construction <br /> That I am*ho-'ed 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 ROW and 296.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br /> riD <br />