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�� r• • . <br />PERMIT APPLICATIO <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 />SITE ADDRESS: ,� /+ PROPERTY TAX # PERMIT.#L f� <br />'�� �� ��`Vi'.!� /'Y�%E- ,s �^i8r�� � ��'�O`"��O('r.?C-�j n�/i fl�l �_I� ' <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �C� �E��F"�L-y Phone/E-mail '71-� � ��� B - l r� � <br />Address ��-� �-�' j�-`%�NG .iv �`fr- �. City/State/Zip ,�V ��[-E`�// �+!Vf� , '����� <br />APPLICANT: _ Owner _ Owner's Agent ,l�Contractor <br />CONTRACTOR �'�!i�l� 1C /'���/� �./�/E��y ,S, <br />Address �C�: %� 4� �'�,�+' � %� ! � „�r�y��iL(r <br />_ Contractor�S AgBfli _ T2f18f1I (must provide a letter of consent from the owner to do work in the space) <br />,�itC�� State Lic. # ���N JL4, �;'� �°�y� J'� City Bus. Lic. # � ���� �- <br />�.�IJiQ._ �i�Cr t Phone/Email y%.�'��'"����`C s/,�NDAI���-('c.A/L�Fi <br />CONTACT FOR PERMIT N�S <br />�j�-l.�r.� �!E <br />Phone/E-mail �����b/�����^ /�,`yr/r/l,�til���-N��: 1 o�,M�a/. <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `� -`�t-`c' <br />� � HEAT SOURCE: <br />Existing Use of Building J��-- <br />Proposed Use of Building ����'""� Gas Electric� <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition �Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Char <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />/',�/;'�'A.c,L-r�/v� ,/@ ,�,Jr �„a✓ �G�L—�'c� rS t���s i /�t'/.'^!` <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Number # of fixtures <br />A/C - air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fireolace <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 this type of work will be comp <br />with whether spe d herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am aut iz by t owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�� <br />�3-�7--1�i <br />Owner/A horize ent Signature Date (Revised 9/2014) <br />� � <br />/. �t�nA <br />n� <br />