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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:2400 6 r,) Ave-, Evert4 <br /> PROPERTY S e Q Che PFAM T ®C 03S <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNEROWNER f'ffli kperfcQ 6/ine�c c Maniere-P Phone/E-mail if z..5"-- Foe/-/oa f <br /> Address f 0 j'z 1324I:l/ ,WA chrU City/State/Zip _,#' W <br /> APPLICANT:.. Owner Owner'sr'fAgent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR A�V)b d £ 1 c lrL1.-L L- State Lic.# p yo Q City Bus. Lic.# <br /> Address gO — 1 '3 2 4/ Phone/Email <br /> TENANT BU120 <br /> INESS NAME CONTACT FO2�PERalkT 6,:#7, „fey <br /> V6lail ✓ Phone/E-mail I-4.44 e ®a <br /> T-A <br /> ewi.r, ,,C A <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Lc1( 000 r 001 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 10 I X4 Vilei 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 /> /119-H D Ver r e-i-a 1 5 pa ce. <br /> MECHANICAL PERMIT APPLICATION <br /> I PLUMBING PERMIT APPLICATION <br /> Type of Project- New'_Addn_Alter to lore"—Repair TypesdProjeet_N W- AacJiii-t'''''A_Ite[AVIA Reps E— -: ` - <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units Toilet <br /> Forced air systems I Bathtub <br /> 1 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 j Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump. Backflow preventer <br /> Unit heater j Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM i Other: <br /> Number of Heads I 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 specific 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 am authoriz b 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 296.200A WAC. <br /> 0 Owner/Au orized Ag t ignature Date (Revised 3/20 <br />