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���.�o� ����Q������ <br /> �u���������������,������������s����s��et�������������'�o� <br /> � CITY OF EVERETT P�RIViIT SERVICES <br /> 3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITEADDRESS: PROPErtTYTAX# ' I����` O`� <br /> � <br /> ., v� . lJ�' � <br /> L�GAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER �� �, / Phone/E-mail ' � '��,-, •-- <br /> Address � �(� . �i� CitylState/Zip <br /> APPLICANT: Owner _Owner's Agent �Contractor _Contractor�5 A9ef7t _TEflBflt(must p�ovida a letler of consent f�om Ihe owne��o dp work In the space) <br /> CONTRACTOR /�1 �j�� �, ' State Lic,# 7�L��...,�C,.�. � � City Bus. Lic.#G � � <br /> Address ����C �`7� � �. C �� C �� PhonelEmail ` ..J �. '7' ,�1 ��� ��� ��' <br /> CONTACT FqR PERMIT • r�'�'�l <br /> Phone/E-mail <br /> BUI�DING PERMIT APPLICATION coNTRACT PRICE oF WORK /,��X')d� <br /> Existing Use of Building � HEAT SOURCE: <br /> Froposed Use of,Building Gas_ Electric_ Other <br /> Building type: /` Single Family _Dupiex_Townhouse _Multi-Family _Commercial <br /> Type of project: New _Addition �Remodel _Repair_T.I._5ign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): 9 � <br /> /�St�IC��� c'✓�C��// �/�!?/� i `7 L'%\� �^' / ��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Proje�t: _New_Addn _Alteretion_Repair Type of Project: _New_Addn ,_,Alteration_Repair <br /> 5how Number(#)of fiatures Show Number(#)of�xtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavafory(wash basin). <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan ' Sink (service/bar/mop/etc,) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater llrinal - <br /> � Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting � Roof drains � <br /> � Other Medical Gas <br /> SPRIIl9KILER / SUPPRESSIOId �1(STEM Other: <br /> Number of Heads Other: <br /> I hereby certify ihat 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 whelher specified herein or not.The granting of a permit does noi presume to give authority to violate or cancel ihe provision of any other staie or local law regulaiing consiruction <br /> That I a �iorized by ihe owner of this propetty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> O ner/A horize t Si nat re , Date (Revised 4/2015) <br /> � ' <br /> �� <br />