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425-252-1666 c.m.heating 15:58:19 11-23-2015 <br />BUILDING/MECHANICAt•LUMB(NG/SiGN/SPRINKL�/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 9H2O1 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ITEADDRESS; <br />rax a <br />=GAL for new �anstructian: Shart Plal/suhdivision Lot Tlo. (attach copy o( fong legal descriplion) <br />WNER ( � <br />Idress � <br />�PLICANT: _ Ownar _ Owner's Agent <br />JNTRACTOR <br />dress � '' <br />:NANT BU5 <br />Phono/E-mafl <br />Cily/51a1e/Zlp <br />Contractor � Caniractors Agenl T8�3R1 (must pravtda a Inttarof c;nsant trom Uia owner �a do Ncrk vi tho epa=u) <br />State Lic. # ������ City Bus. Lic. # �� I�/v <br />�x�� V� � qS�or Phone/Emall ��5 25q l�lol� <br />CONTACT FOR PERMIT <br />�� L►h,� li'2�J �� LP�Plo�O , <br />UILDING PERMIT APPLICATlON <br />CONTRACT PR10E OF WO <br />isting Use af 0uilding � <br />oposed Use of Building <br />iilding type: _ Single Family ` �uplex Townhouse ! Multi-Family _ Gommercial <br />pe oF project� New Addition Remode! Repair T.I. Sictn Sprinkler <br />�SCRIPTION OF WOR (additranalspace providsd on the 6ack): <br />���, �-�- �`— <br />MECHANICAL PERMIT APPLiCAT10N <br />po of Project: _Naw _Addn �% Altaration _Ropair <br />ShowNumher ti) ofllxfurQs <br />A/C — air handlin units <br />� For�ad afr systems <br />� Gas i in <br />Water heater <br />Gas range <br />Clothes dryer <br />fan <br />Heat <br />Unit I <br />I Refriqerafion <br />� Woodstove <br />Ductinq <br />�—Other <br />SPRINKLER / SUPPRESS[ON SYSTEM <br />Number of Heads <br />� <br />�, <br />HEAT 50URCE: <br />Chanqa aFUse <br />PLUMBING PERMIT APPLICATION <br />7ypo of Projnct: _New,^Addn `Aiterat3on,_Ftopair <br />Show Numbor (�) of trtures <br />Tailet <br />6athtub <br />Lavatary (wasf <br />Shower <br />Kitchen sink 8 <br />Clothes wash <br />Water heater <br />5ink �service, <br />Backflow pre� <br />Qrinking Fou <br />Floor drain <br />Grease trap <br />Roof drains <br />Medicai Gas <br />Other. <br />Olher. <br />ereby cartity that I hava read snd axaminad lhfs appf cation and know tha same la be We and corract. All provfsions a( laws aad ordinances govarning this type o( work will ho �omp� <br />ith whether �pecified harain or not. The granfing of a pertnit does not presume to giva euthaMy lo vlofate or cancel Ihe provieian oi any other stata or local IaN regulaGng construdi❑n <br />iat I am authanzad 6y lha owner al lhls property to pedorm tha work tor ich appflwtion is made and I romply with the State Conkadors Law 18 27 RCW and 246200A WAC. <br />. <br />�'� � � <br />wnor uthoriznd Agant gnaturo ale (Revised �1/2014) <br />1 /2 <br />