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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 />ADDRE�S$: �� n\� P ERTY TAX # � PERMIT <br />u� I,.�T �,�fi�-.�;,ti t� ?���; �, t��(:��'_i2��i��r� ��'��`d �►L� I��C�-1�t> �'�l t� C��� - D% <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />i{=�'i; =11�� ,�i� -- <br />PLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor's Agent _ Tenant �mu5t P�o��de a iener of �o�sent rrom me owr,e� to do wo�c �o me sPace� <br />CONTRACTOR ('al�j �'�,�� �j}-P;(�c� <br />4ddress 1 :�1�`�. f `l�. � _l �"�� ,,j' , i�r <br />TENANT BUSINESS NAME <br />�,L�nc.a ��iA,k_��1Sp'1�V1C� <br />BUILDING PERMIT APPLICATION <br />L & I Lic. # L,L, (��� <br />�, � -- �- �-t � �`� ' <br />}� Phone/Em <br />CONTACT FOR PERMI <br />� i:� 1�i ����� S� <br />Phone/E-mail .j� �,�� �" <br />CONTRACT PRICE OF <br />v � ��}� �� Bus. Lic. <br />Gti� <br />��('.'ui'n� ��7`: <br />4 <br />N N <br />I� �,�� � --" <br />Existing Use of Building �rl(JL HEAT SOURCE: <br />Proposed Use of Building �.��T I(� 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 _Demolition_Change of Use <br />DESCRIPTION OF WORK (additiona! space provided on the back) :�n ��� Y'��� ����� � S� � �� �,��•�'1(� <br />� j� U d1► �- ;{ f�Y� �(Vf';� Y�C c`Yl . <br />�e 1cCc� � (� cl i F���,� , <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn �Alteretion _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Ciothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of Fxtures <br />Toilet <br />Bathtub <br />Shower <br />Kitchen sinH <br />Dishwasher <br />7 <br />Water <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 We and corred. All pmvisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancef the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perfortn the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />. \��/ <br />. l � �� l� � <br />wn r/Authorized Agent Signature Date (Revised 6/2012) <br />