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• • <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 TAX# PERMIT# <br /> ie, t)OL/ 7/6 770 3/OO 1)13a--)-006' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Fel Hi Aife,-/Gq aimersMa/lee1-LP Phone/E-mail (y-2.5) ,o K-/b 00 <br /> Address Po BOX /;2i / City/State/Zip 7 1 b'4'—T ft, Wv/'r 9 0 6 <br /> APPLICANT: Owner _Owners Agent _Contractor _Contractors Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR AAiL 0 (/8,75 f _ Lc - L& I Lic. # f /V/Pee Li6B 3 co G COE Bus. Lic.# <br /> Address /�G' X 16 Q N 712_4)4- Phone/Email (y25 ) Zoo- C "?E / <br /> TENANT BUSINESS NAME CONTACT FOR P RMIT <br /> if--4//0/1( eO/ d <br /> Phone/E-mail(310 722-6, 9,Z <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> • <br /> Existing Use of Building Gi )Cu( 1t i HEAT SOURCE: <br /> Proposed Use of Building 11101\'l F�c / 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 /> fl\O [2 W17 <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 /> 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 j Dishwasher <br /> Clothes dryer I 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 I 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 am 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 296.200A WAC. <br /> F1/4// <br /> Owne Aut orized gent Signature Date (Revised 6/2012) <br />