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0 0 <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY rax# E <br /> 2 2 iD �sr # (1k 2 . <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (at)tach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address 7/ �0� j s� SGt� City/State/Zipv��� Zi0 <br /> APPLICANT:-X Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letterofconsent from the owner to do work in the space) <br /> CONTRACTOR L&I Lic.# G COE Bus.Lic.# _ <br /> Address Phone/Email Z�J 3/3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> / <br /> Phone/E-mail ?�i(l�) ! - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building IZf.S/pht all- HEAT SOURCE: <br /> Proposed Use of BuildingGas_ Electric_ Other_ <br /> Building type: _Single Family Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition Remodel _Repair_T.1._Sign_Sprinkle._Dem iti n_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> r-ENoui iw) of- ;e�?a5To pcP �• <br /> ZUR ell <br /> GO(j 2 G?2 <br /> MIE—C—FINMIGAII PERNINTAPP11111CATIOW- 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 /> was range DishwLisner <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 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 amed 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 /> C=am Z I I f Z- <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) �/Z <br />