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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:/9/6, (wle A/C- PROPERTY TAX# ATM—,- <br /> JF#� ,— _ouy <br /> �oc <br /> LEGAL for new constructions: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> Med ed Axu/) Phone/E-mail <br /> Address 111�V d/-, City/State/Zip 4U/'t/ '1/-, 75 <br /> CONTRACTOR 5-c L&I Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Cq ( Cf d iG'I*) C4rf{M tp`-)� S Phone/E-mail -2,-)6­)7q- &,o <br /> BUILDING PERMIT A PLICATION CONTRACT PRICE OF WORK �61 /V J <br /> �/ J <br /> Existing Use of Building Gf�G���P'/S! //`t ii HEAT SOURCE: <br /> Proposed Use of Building ��G�fM��/S`re 1G', l 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): ya1 <br /> u>(,5'f ^� �e( t ca ��,rC� elcoOL +0 f-edWQ- ' 0 /CSS 741,�;,7 /'g/ U4 <br /> Have you started working without a permit? _YES _KNO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _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 /> 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 /> Number of Heads I Other: <br /> 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 /> toperform work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> -� �// <br /> Own r/Authorized Agent Signature bate (Revised 2/2011) <br /> Z <br />