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PERMIT APPLICATION <br /> BUI:DING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar 5t., Everett, WA 98201 425-257-8810 f-'P,X 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMIT K <br /> I L Prt,,-�- � -D <br /> LFGAL for new convruction: Shon PlaVsubtlivision Lo;hb._ (atlach copy ol long legal tlescription) <br /> OWNER r ,L �� t � PhonelE�mail `'��� SU � SGy� <br /> AOtlress � �� /� ��� �dv'�- CRy/SIale2ip <br /> APPLICANT: Owner OwneYSAgent _Cantraclor CoNraclarsAgent TCn3nt�mu:iwo.+enuiuuuraiconmmxemmnw.nerueo..oninmospnuy <br /> CONTRACTOR Moe,� PrU., h�',n StateUc.teMOC/�P�'�- .>'JU crtys�5. uc. u053�35 <br /> 4a5 7b� 5-16v/ I <br /> Address �7S� 5 y�`—�S�- SG SiW c�n��t�. (.J ��f �l�Z�tU Phone/Email jl �.} Mu:+�lM�nrw , co�. <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> PhenNE-R ad <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Buddmg HEAT SOURCE: <br /> Proposed Use o(Bwlding Gas_ Eleunc O�her <br /> Budding type: _Single Pamily _Duplez_Townhouse _Muili-Family _Commercial <br /> Type of projecl- New Addilion Remodel Repair_T.I. Sign_Spnnkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(add�tiona�space p�o�maa on�nc�ack): <br /> ,1 r y�z I c L l-e c� � L,c. I Yt �z.��. �6- �" ��V o,� �,-.,�, �e.r <br /> h��l� �•7^<- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Atltln _Alte�ation_Repair Typo of Project: _New_Addn _Alleration_Ropair <br /> Shmv Number(pJ o!firtures Show Numbcr�N)o/firfures <br /> A/C—airhandlingunits � loilet <br /> Forced air systems � Bathlub <br /> Gas pipmg � Lavalory(wash 6asm) <br /> Water heater � Shower <br /> � Gas Greplace Kitchen sink 8 disposal <br /> Gasrange Uishwasher <br /> � Clothes dryer Cbthes wisher <br /> ' Range hootl Water heatcr <br /> � Exhausl fan Smk(service/bar/moplelc) <br /> Heal pump � E3ackflow preventer <br /> � Unil neater Unnal <br /> � Boder � Drinking Fountain <br /> Retrigeration Ftoor drain <br /> Woodslove Grease trap <br /> I Ducting Rool drains <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM o�her: <br /> Number of lieads Other: <br /> I hem5y urtry thai I Mva mad ond e�aminetl Ih�:appP,ralion pnC Mnow Ihe samo to Ee Uua end wrtect.All pmvisions ol lnw.ana o�E�nnn:cs poveming Inis rypo ol vrork wJi Oc comF��r� <br /> wi�wneinerspccFCEherclnorno� rnegmmm9olapermilEoesnolpresumeloglveaW�onlytov�ola:eorwnulthepmvlslonolanyoIDerstateorlaallawmgulatingconslruc��on <br /> inai I am n�n�onrrE 7y�he ov.ner o7 inis proDeny lo perlorm Ne work for wMc�aDCIIcolion Is maEe an01 comply wtl�tne Slale Contraclws law 1827 RLW enU 296 400n'h',1C. <br /> �����- y-z�-� �- <br /> OwnodAulhorized Agent Signature Date (ReviseC 3/1013) <br />