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{ <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/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 q �7J� ��I <br /> SITEADDRESS: PROPERTYTAXM P MI i <br /> /� � �w� � �-Uv�/ <br /> LEGAL lor new conslruclion: Short PlaVsu6Civislon Lot No._ (attach copy of long legel descriplion) <br /> OWNER ' D Z NCl.�J,� L, L G /1.T f�R�" CJ <br /> aaare5g p -Z qasia�e,zic L!/ �l�Zb(p -szil <br /> CONTRACTOR Q mo to ?" <br /> Addreas 1_, Z � Phone/Email yj2.5 ��.� Z—s <br /> TENANT BUSINES NAME CONTACT FOR PERMIT <br /> C��� Phone/E•mail YeMO�.,�?.�F�"�v � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �J�t,l�0 <br /> Existing Use of Building Lt] � �� HEAT SOURCE: <br /> Propased Use of Buiiding � ���G_ Gas ectric Other <br /> Buiiding type: _Single Family _Dupiex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DeScriplion of WOfk(additional space provided on fhe beck): <br /> (�)N��� w,�vo��s ,DC�o �NrE2ro2 ���� �cs c zNo �rc2 , D�� o c�c,. � �(lS,a <br /> ;'-�'S�j��� T1�a� ccG . <br /> Have you ataAed working without a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypealProject: _Naw_Addn _Altoratlon_Rapair TypaofProJact: _New_Addn _Allentlon_Rap�ir <br /> Show Number(N)olllxtures Show NumDer(M)o//7ufurea <br /> A/C—air handlin units I Toilel <br /> � Forced air s stems Bathtub <br /> � Gas ipin Lavato (wash basin) <br /> � Water heater Shower <br /> Gas fireplace Kitchen sink 8 dis osal <br /> � Gas ran e Dishwasher <br /> Ciothes d er Clolhes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/barlmop/etc.) <br /> Heat pump � BackOow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> � Refrigeration Floordrain <br /> Woodstove Grease tra <br /> Ducting Root drains <br /> Other Medica�Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> I here6y certily that I have read and examined ihis application antl know Ihe same�o be lrue and conect.All provisions of laws and ordinances governing <br /> Ihis lype o1 work will be complied wilh�vhether specifed herein or not.Tha granling ol a pertnit does nat presume lo give authority to violate or cancel <br /> Ihe provision ol any olher state or local law regulating conslruction or Ihe pertermance of cons:ruction.That I am aulhorized 6y ihe awner of I�Is praperty <br /> to pedorm thc wo�k lor which appllcalion is m7da a9}I comply with Ihe Stale Coniraclors law 1827 RCW and 296.20D WAC <br /> � �//� �U.G�'i��FC� 1 <br /> OwnerlAu odzad Agont Signeture �ate (Revisatl7/l071) /� <br /> � <br />