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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 vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ;` _-� 1 <br />ADDRESS: , % PROPERTY TAX # PERMIT # <br />i �c� -=1 I' .�� -=�; � � � t�C>�Zc� � vc>c�a�,�v ' �� i-��� <br />�L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />Z� ri ►�l � rL•r;� �J G���. <br />�� �C 1 j ZZOlv <br />Owner _ Owner's Agent .�Contractor <br />1 � <br />��a�..� .-� �> �v �s �.� � �-� � ,-�►G <br />BUILDING PERMIT APPLICATION <br />,�G , Phone/E-mail � L-,S "7 �7 ,�� 3 �� Z Z., <br />City/State2ip 1 2v 1 w[� �� � .•j � � <br />Contractor'S Ag6�t _ T6ft8flt (must provide a letter of consent from the owner to do work in the space) <br />,� L& I Lic. # ��,�},''�F�� 3 j� COE Bus. Lic. # <br />S�i.✓Af: i�� 2� ��� ��. C�ti i+�1 <br />?� <-'��� �`3� Phone/Email _ ye <br />CONTACT FOR PERMIT <br />•� vv► ✓� i� i.J.4 2� �i f� l� i s <br />Phone/E-mail , j i i= w':-1iZ i" jZ�-= r Li .=. C.�.:.v� <br />CONTRACT PRICE OF WORK �, r``X'af'r �''' <br />Existing Use of Building �rFi�G � <br />Proposed Use of Building_��=F i Li <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �"Commercial <br />Type of project: New Addition �Remodel Repair _ T.I. _ Sign �Sprinkler _ <br />DESCRIPTION OF WORK (additional space provided on the back): ��A� U�r.� <br />�r `��,v �,:a.�� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />� Forced air systems <br />' Gas piping <br />I Water heater <br />' Gas fireplace <br />fan <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />�Z-�- Number of Heads <br />HEAT SOURCE: <br />Gas_ Electric Other <br />Demolition Change of Use <br />Y'�.�i�'�.''C'�� 4'0.��'-��-S <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of Fxtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moE <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Fioor 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 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 cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this roperty to perform the work for which application is made and I compty with the State Contractors Law 1827 RCW and 296200A WAC. <br />,- � � - `�� <br />�.�- `� �--./ _. z _ z_i <br />Owner/ thorized Agent Signature Date (Revised 6/2012) <br />�� <br />