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i� <br />1����0`� �,p1���QC� °;`�0�� <br />C��91�����/�dC�1����9V��a�,l�����8��/���G�/�pI�B�C�L��G�I�G�`d��p`���� <br />' CIiY OF �!/Et���i P�RY�iI�' ���1/I��� <br />3200 Cedar St., Everetf, WA 98201 �25-257-8810 FAX 425-257-8857 www.everettwa.org <br />', SI � R��A�� � ' IP��°A2QOS l?OD�O 7� I �P t!(/Oq - <br />—� — <br />�GAL, for nev✓ construction; Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />oWNCR b`�E((� �(�-(�p ��,�,� ISC� PhonelGmail �{ZS � 25 - 41322 <br />Address �. �. �oyc, �(P �� �o City/State/Zip C��(�j0 (,L p(�O6 <br />AFPLICANT: Owner _ Owner's Agent _ Contfactor _ Contractor's Agent _ Tenant pnu5t provido a leu�r of �onSBnirrom u,e ownEr �o a� wor�c In m� Spa��) <br />CQNTRl�GTOR �-:V � o� ���=-C� �?-Rc� � ����lLn� Staie Lic, # ���i�(s�`��sZ� (J B � City Bus, L.ic. # �'str'l6L�`7 <br />Address ��'`�v �d�f,� ���--� ��%".r',(�"�'�. i.t.t� ��GO�� Phone/Email ����'Z��. j%��l <br />- CON�'ACT FQR PERMIT <br />I�tdt� °���[ �+'� ��SS M w �4 . Ca H-t <br />v l2E � c,�Y s (ScU i� �'4'✓�j Phone/E-mail 'T 2�� � 2 7 Z— 3��� <br />�UI�DING PER�VIIT .APPL.ICA,TION co�vT�aacT PRICE oF woRo-c 3�05 <br />Existing Use of Buliding I�io c�,IJG � <br />Proposed Use of Building 1� � C��� °� <br />Building type; � Single Family ___, Duplex _Townhouse _ Multi-Family � Commercial <br />Type of projecf: _ New uAddition _ Remodel � Repair_T.I. _ Sign _Sprinkler_ <br />DESCRIPTION QF WORK (additional space provided on the back): � <br />(Z�t.oVG � �-c�l�c� ��Sr,�ub U�v �T µE� - S+�s` ���I��t <br />M <br />IT <br />ofProjeof: _New_Addn _Alferation T Repair <br />ShowNumber(#J offixfures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes drye� <br />� Range hood <br />� Exhaust fan <br />Heai pump <br />I I Unit heater <br />1P`�' Ii�N �P''r / ��JI9�&��'���11�6�1 �����hlil <br />� Number of I-leads <br />PLUM�ING <br />HEAT S�URCE; <br />_Demolition_Change of Use <br />� Lo G�t'T i D r,t� <br />Type of Project: _,Nevr _Addn ,_,Alferation _Repair <br />ShowNumber(#�) offixfures <br />I Toilet <br />�.�vatory �wasn i�asin). <br />Shower <br />f<ifchen sink & disposal <br />Dishwasher ' <br />Floor drain <br />Grease trap <br />Raof drains <br />Medical Gas <br />Other. <br />Other: <br />n <br />I hereby ceitify that I have read and examined ihis appllcation and know ihe same i❑ 6e irue and correct. All provisions of laws and ordinances governing Ihis iype of work will be complied <br />tviili whelf7e� specified herein of not. The granting of a pe�mit does noi presume lo give authority to vlolaie or cancel jhe proVlslon of any oihef siate of local law regulating consiruetlon <br />That I am authorized by ihe otvner of this property to perfoi7n ihe Wo�k for which application is made and I comply With ihe Siate Contraeiofs LaW 1 �.27 RCW and 296.2DoA WAC, <br />� � q�` I �� 10 <br />�wrreri•f�uthor' ed yent Signature Date (ftevised 4/2�95) <br />