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PERMIT APPLIGATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.evereitwa.org <br /> APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM <br /> SI7E:IDDRE55: , PROPERNTAXNv,L� ��l-�S PERMIT# -�1 ( <br /> �I�11�1 L��.�,��, w. <br /> LEGAL for new construction: Short PlaVsubdivision Lot No._ (attach copy ol long le�al description) <br /> OWNER �` L "t"� �SJ� �� '� PhonelE-mail <br /> � � � Q�� ��S�J� <br /> I D I 1-� ���v,,�. S't- . City/State/Zip (..�ivli,i�tYlr� � � <br /> Address <br /> , .�-, L& ILic.# rv����L�15'i ;2 <br /> CONTRACTOR ��z �"� I��'rl'�'��� <br /> �7 � � "i-. t�1''<- , w/1 1 i � ` <br /> c', � ,? O PhonelEmail LLxo' J�,� ' I 7 �'� <br /> Address �v � !C�^��''L �� ��T <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT/}�e j I7����,y,�.� <br /> � ��--- Phone/E-mail '✓0(�-i f�j-- ITN� e.:�. ZN?, ���E.�e,rr.-.�e.��^�/.::.�w^ <br /> BUILDING PEZMIT APPLICATION CONTRAC7 PRICE oF WORK ��' I5,!>> i. U� <br /> HEAT SOURCE: <br /> Existing Use of Building — <br /> Gas Electric_ Other <br /> Proposed Use of Building -- <br /> Building lype: _Singie Family _Duplex_Townhouse _Mullj•Family _Cortimercial <br /> Type of projecl: _New _Addition _Remodel _Repair�T.I._Sign_Sprinkler_Demolitirn_Change o(Use <br /> Descriplioflo(Wok addifionalspace rovidedonfheback): � �,��.�-c b:cv� t��c�+"""= <br /> �{ ( P L ,y�c ( t �n.v:F-7 2v� � i I <br /> 1.,,;; ,'�-'Er,, ,l" bncUA �1�v, ;�>i.�Fy'ISM`^ �..'i. �o�•^�, � <br /> � � i <br /> � , '�ILC / r�,�r�'.HlS <br /> ��, • � <br /> Have you starled working without a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot ProJect: _New_Addn _Alteratlon_Rupalr Type ot ProJecl: SlwweNumber�(#J ol R tures`Ion_Repalr <br /> Show Number(pJ o/flxfures <br /> A/C-air handling uni�s Toilet <br /> � Forced air systems : Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> Water heater I Shower <br /> � Gas freplace I Kitchen sink&disposal <br /> � Gasrange I Dishwasher <br /> I Clo,hes dryer I Clothes washer <br />"1 � Walerheater <br /> � Range hood <br /> I � Exhaual fan I Sink;service/badmop/etc.) <br /> � Heat pump I Backflow preventer <br /> � Unit heater I Urinal <br /> � Boiler Drinking Founlain <br /> �� � Refrigeration i Floor drain <br /> Woodstove i Grease trap <br /> i � Ducling I Roof drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I other. <br /> � Number of Heads Other: <br /> I hereby certify that I have read and ezamined lhis application and know iha same lo be lrue and wvecl All pmvisions of laws and ordinances goveming <br /> this type of vrork will be complied vrith whether speci(ied herein or not.The granting ol a pertnit does not presume to give authority to violata or cancel <br /> Ihe pmvision of any other state or local law regulating constmction or ihe pedormance ot constmclion.That I am aulhorized by lhe ovmer of ihis pwperty <br /> to peAorm iha vrork for which applicalion is made and I comply with tha Slate Contractors Law 1827 RCW and 29G.200 WAC <br /> �i.��r,� -�f,�, � ,.L <br /> Dale (Revised 2/20f 1) <br /> OwnerlAuthadzed Agent SIgn�Wre / <br /> 1 Z <br />