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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/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 <br /> SITE ADDRESS: Q i rr�f^ PROPERTY TAX# PERMIT# <br /> .t lF.. !<` "_ > Q.f.,,;i Lam" /( f r1l��:Ff •- fit. 2 <br /> u <br /> LEGAL for new construction: Short Plat/subdivision----------------_ __________Lot No.____ (attach copy of long legal description) <br /> OWNER .® �.J�'t I+ Phone/E-mail <br /> Address "� a4 ,. : h 7� City/State/Zip <br /> CONTRACTOR <br /> � r 1. L& I L�ic.# ", i w'�.(' <br /> Address 9 ct' r a C I`,`� �t; � l�G ' Phone/Email WLS <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building------------------ HEAT SOURCE: <br /> Proposed Use of Building Gas____ Electric____ Other __ <br /> Building type: ___Single Family ___Duplex__Townhouse __Multi-Family _'Commercial <br /> Type of project: __New _ Addition Remodel Repair T.I._ Sign___Sprinkler__Demo]ition__Change of Use <br /> Description of Work(additional space provided on the back): <br /> Have a e you started working without a permit. ___YES tz'_NO <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 /> =. <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 Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> i <br /> Number of Heads 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 authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perfp.Vrn the work for which application is made and I comply with the St to Contractors Law 18.27 RCW and 296.200 WAC (21 <br /> Ow r/A onzed Agent Signature Date (Revised 2/2011) <br />