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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 w .everettwa.org <br /> Intl D 1,610-►- wwCU* . ge) <br /> SITE A•■ 'ESS. PROPERTYWIt <br /> / Q <br /> 'tt isS ' 1rr0■ I. ti• aco(t D /LI <br /> TiFD- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER i�a einaylcial teWI3YW Phone/E-mail (g141-) 31 5- e9500 <br /> Address P0. City/State/Zip )u.ry <br /> / <br /> X � 'l�a�k)coy, 0 tog 13 <br /> APPLICANT: Owner _Owner's AgentI. ontractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR P 1 ES N ( %Cal State Lic.# ES Me 1 S q 3- <br /> CONTRACTOR Bus.Lic.#5y'b�0"f' <br /> Address of 1 P\� )lathssee AL 3 ,3,,.,...a 3H2 . u.�,,t,� <br /> TENANT BUSINESS NAME I C NTACT F R PERMI SQra�a�w�c�•►.C��l, <br /> \ � `��( g �//�/��/► �� /�A.c�a�d-i+� sGt�ra@a�n�ch ,camdVaA ree is Phone/E-mail (S34)4,15a–b3Va <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK kii 't ea <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 §prinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Ytw& e 41 1St\4,ce (9 It'hit <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 /> NC-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 /> Ductin . Roof drains _ <br /> (Q Other I t- S Medical Gas <br /> SPRINKLER/SUPPRES ION 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 ,hether 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 /> Tha t m authorized 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 /> !,1 / A.44,61,,,,_, 3-a�---4g•caner/Authoriznt Signature Date (Revised 9/2014) - <br />