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PERMIT APPLICATION <br /> BUILDING/MECHAINICAL/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 ADJ R S- PROPERTY TAX# PE IT# <br /> W EASIN�7 U i7 Tr 61. 6 =VC? <br /> LEGAL for new construction: Short Plat/subdidision Lot No. (attach copy of long legal description) <br /> OWNER RZI N& /� Z Phone/E-mail <br /> W <br /> Address F6 1 3 10-I7 U NIS A—� J City/State/Zip &JJJL,jr,, WA aN1ZJ--2:Z0-7 <br /> APPLICANT:—)(Owner —owner's Agenl _Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# =)F °L�J Z 3 C L City Bus. Lic.# 040 91' <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 3 DM`f M -4 A5-23'9-v 1T 2 <br /> Phone/E-mail IZM <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building M Fc HEAT SOURCE: <br /> Proposed Use of Building M FC? Gas Electric Other_ <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family Commercial <br /> Type of project: _New _Addition Remodel _Repair X T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional spEice provided on the back): <br /> R lr ri�/U- Fit Js r�,�e v f�i�� s l -r� 9 7;k A JG&d6 y /hen/� c o� ,tJ <br /> �D 2 S•�/ 1�-L ;�.75 -- � Ii�.�. ��L-�h,v �rZ��-�'J C�" �t 5 d`t-�%��- <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 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 /> Ducting Roof drains <br /> Other Medical as <br /> SPRINKLER / SUPPRESSION SYSTEM 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 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 /> 7/ <br /> S k <br /> Owner/AALWoriAVAgent Sighlature Date (Revised 3/2013) <br />