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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: PROPERTY TAX# PERMIJ,# �'0 <br /> '7—,q t 3 .�+.t.��zt ova i�� Jac I L <br /> LEGAL for new construction: Short )Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ( L'�UA4131 A Phone/E-mail <br /> Address Lq 3 Vt t L-, o L City/State/Zip <br /> CONTRACTOR0- <br /> 2 <br /> Address �2,�� X�C AvC UaLgr t�Aq,;Nol Phone/Email C�5-2'52-311� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> L-L'/G'i' )t� Lc Phone/E-mail 9 2` 2 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ 1446L! <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building �l rrT r"� Gas Electric N Other <br /> Building type: _Single Family _Duplex—Townhouse _Multi-Family _X-Commercial <br /> Type of project: _New _Addition _Remodel _Repair-X_-T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the back): <br /> V,006 t*l57µ6 5 +�q4 5Pt-f 5.y 5tCO..�- . ov7D001- VA),-t z)/J GrWA�o <br /> Have you started working without a permit? _YES _ANO <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 /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> i 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 I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ( Other: <br /> Number of Heads I 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 p�the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> 0Vrn-e?,/AuthorigU Agent Signature Date (Revised 2/2011) <br />