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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS IZ3t �l'u,�4RD ✓ PROPERTY TA <br /> Oo392239V)(000PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER .�, Phone/E-mail <br /> Address E City/State/Zip M4W4 %Z01 <br /> APPLICANT: 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 &' ) �IA-)C. , L&I Lic.# (� COE Bus. Lic.# Cal <br /> Address 33 W. � (,4 L) 1/ m— / Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jo PE,SE <br /> Phone/E-mail ZS Z-3 ell—4W 317 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK��,61510 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other_ <br /> Building type:XSingle 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 /> ��- JZ�-tea-xe. to l Z '�. c�c 'P7 <br /> wAu -ta M.cxcr e cmc_ crb PsF Lw� f2 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration Repair Type of Project: New_Addn _Alteratio 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 /> j 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 complied <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 amuthorized 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 296.200A WAC. <br /> k2e / <br /> !3 <br /> Owner/ ed A tgnature Date (Revised 6/2012) <br /> Z <br />