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����n�i� �����c��i � <br />�uiL�i���nn�c���oc�����.unn�i��rsi��u�s��irv�L������no�s�rwo� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRESS: <br />� � s� � u����r� <br />�L for new construction: Short PlaUsubdivis <br />ER /,, ,�a ,� , r� /., n��7r' � c <br />��n� <br />CANT: _ Owner <br />ress <br />�1�r�'�C'� <br />Owner's Agent � ( <br />. l ^ %7 / i ? <br />PROPERTY TAX # <br />Lot No. (attach copy of Ibng legal description) <br />Phone/E-mall � �/2 S'� 1 jh�5/L �� <br />% City/State/Zip <br />- r <br />ctor _ Contractor's Agent _ <br />State Lic. # <br />-v z i <br />�'rir�.:,-' �� �t�� A- t�' � /�� <br />T8118�I (must provida a letter of consent irom the owner �o dp work In Ihe space) <br />•;� <br />��t`�v!'�i��,r ;7 ���� .P ' S City Bus. Lic. # �., / ��. %1 <br />PhonelEmail �Lj7 S=- f 5'� j[r� ej t� <br />C'"� �� /' � r� �,}�'iS�' ��/" �c t <O ''l . Phone/E-mail ( �%2 S ", / � c� !/ c . <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r ��� <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: ,_ Single Family _ Duplex _Townhouse _ Multi-Family ^ Commercial <br />Type of project: New Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />MECHANICAL PERMIT APPLI(:A 1 <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />—� Forced air svstems <br />vvater neatE <br />Gas fireplac <br />Gas range <br />Clothes dry� <br />Range hooc <br />Exhaust fan <br />HEAT SOURCE: <br />Gas _ Electric_ Other <br />Change of Use <br />PLUMBING PERMIT APPLICATI <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 & disposal <br />Dishwasher � <br />Clothes washer <br />Water heater <br />r <br />� Boiler Drinking Fountain <br />Refrigeration r Floor drain <br />� Woodstove � Grease trap <br />I Ducting � Roof drains <br />� Other Medical Gas <br />SPRIIVKLER / SU�'P92ESS101d SYSTEPNI Other: <br />Number of Heads 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 lype of work will be complied <br />wilh whether specified herein or not. The granting of a permii does not presume to give authority to violate or cancel the provision of any oiher staie or local law regulating construction <br />That I am authorized by ihe owner of this property to perform the work for which application is made and I compiy with the State Contractors Law 1827 RCW and 296200A WAC, <br />(Revised 4/2015) <br />�'�2 <br />