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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — wvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM II —17% -IZ <br />SITE ADDRESS: „ <br />PROPEcYR If, r► <br />RMz rI <br />o -� <br />LEGAL for new constmcction`: She r/t�Plat/su ivision___. _- _- ..Lot No.____ (attach copy of long legal description) <br />OWNER <br />S ou <br />Phone/E-mail <br />Address <br />city/State/Zip <br />CONTRACTOR <br />"1- <br />L & I Lic. # r <br />Address r (.%t) ``-' i Phone/Emait7i,�W[p�.p/'a' � <br />TENANT }BL(SINESSS NAME / <br />CONTACT FOR PERMIT-}--YLv{n�_ -k <br />PhonelE-mail c'1sJ S 6 7S <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK CV�` <br />Existing Use of Building— _ _- _ _ __ _____ __ HEAT SOURCE: <br />Proposed Use of Building______ GasElectricOther <br />Building type: —Single Family —Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: __ New __ Addition _ Remodel — Repair— T.I.1il�'Slgn _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back): �, yr <br />i(L UAXAfe <br />Have you started working without a permit? _YES _ _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _.NowAddn Alteration __Repair <br />Show Number # of fixtures <br />Type of Project: _-_New_._Addn ___Alteration -_-Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />I <br />Forced airs stems <br />Bathtub <br />I <br />Gas piping <br />Lavatory wash basin) <br />Water heater <br />Shower <br />Gas fire lace <br />1 <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heal pump <br />I Backllow preventer <br />Unit heater <br />Urinal <br />1 <br />Boller <br />I Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />\ <br />Roof drains <br />Other_ _ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />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 <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give aulhonly to violate or cancel <br />the provision of any other slate or local law regulating construction or the performance of constmction. That I am authorized by the owner of this property <br />to pedo the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />/D . zh z- <br />t7r/luthorhlflad Agent Signature I Dat (Revised 212011) 1I <br />Z <br />