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�ERMIT APPLICATIO� � <br />��G� � � � <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN LER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FRQM 8 AM TO 4 PM <br />ADDRESS: �.�� PROPERTY TAX # PERMIT # <br />�( 5�� � �� S� 29os ���3�� �c� i�/11��1� -�'��� <br />1L for new construction: ShoR PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER �(`�- r�� �''�`��3 "� L�"^-✓t-� - ��ai'� Phone/E-mail <br />;S � � c � j { `` /k� 5 r City/State/Zip ��,�L-E- � wo-'� °�( � i,b 3 <br />.ICANT: _ Owner _ Owner's Agent _ Contractor ✓ Contractor�S Ag21lt _ T2f1811f (must provide a letter of consent from the owner to do work in the space) <br />1CTOR �vW��^t2,�, IZ��✓��err.���� <br />� ��[ S��F�, i,C�Y�� �t. j�,l�C, w�� (,qi,��� <br />�-���� �tiw����� � ���2� <br />BUILDING PERMIT APPLICATION <br />L& I Lic. #�� �YtG r't. �`� S`� I� Z COE Bus. Lic. #�%�1'I 3 SU <br />Phone/Email "j,b F. —� �� j�- L—L L{ '-i <br />CONTACT FOR PERMIT ���� <br />/�� l3 <br />Phone/E-mail %t56 _�<� -- l�i� 4 W�t. 251 �' /k.lz�, �(y'2�j.�i-,I��.c,cU:-, <br />CONTRACT PRICE OF WORK � I �I , 25G �`� <br />Existing Use of Building HEAT SOURCE: <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 _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />1 , <br />,%v�5.�,i�a�'E" c L.� �"1 4'ti C z. � �n.�J;'✓�"'a\� v`n i i"�j , ((l,Y v � j.b�-i '� i S i"<- � <br />MECHANICAL PERMIT APPLICATION <br />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 />Water heater <br />� <br />� <br />Gas fireplac <br />Gas range <br />Clothes dryf <br />Range hooc <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Gas Electric Other <br />ition <br />.\ <br />�;.r{vv� � �' J <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatorv (wash basinl <br />Shower <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow <br />Drinking Fountain <br />Floor 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 governing this type of work will be complied <br />with whether specifed 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 property 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 />�� �� � � ���"— <br />�,�� i ( . <br />Owner/Authorized Agent Signature Date (Revised 6l2012) <br />