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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/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 FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX q PERMIT # <br />��� 7 ����`` 5i� v� �- � 2����51 `i t�o�/ ��l nc7� -� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER H I �-t' �.j� �i"1Co�')�c; � Ul E' �� ` zC �� Phone/E-mail <br />Address �� i'. .(�iX �C�`��5 City/State/zip �,���(j%'L�� , ���. ���'(��?� <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor's Agent _ Tenant �m�sc P�o��ae a iene� or �o�5enc r�om me ow�e� co ao wo�k �� �ne spa�e� <br />CONTRACTOR iGri'� �Ii�i��� ti; i� �i>I � 11C,� L& I Lic. #�� (�' �"� H E f�L�J��JGI� COE Bus. Lic. # C!y.�.�� Z <br />Address � � � K �;�i,'S 1 fl i ( �IG ( vl�:`� _ L�G�/C.'. � Phone/Email %Z'� "bLl -12i,�' �� r r,iT ' „'CY � _ l-1 <br />I C 1 NV,9ilZ.. CO: <br />TENANT BUSWESS NAME CONTACT FOR PERMIT J�,��`��, �{,�,�'��� <br />� � <br />����� �.-�d� L����►�-�. <br />Phone/E-mail `�L"-�-�'�i-tZy.�j ,�'2.J2,11 �� c:FM•�fl✓.��LtZ-CC;1il <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �I �SCC'. o�` <br />Existing Use of Building IZ�' Z%., � HEAT SOURCE: <br />Proposed Use of Building �F ��i, I ' <br />Gas %\ Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair � T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) :�y�+c �� ���� i��,,-�� �tl�L� CJ'; , ���� �;, �.,�i ��� �� ,� ( C, �, <br />� NX�eI)C� C'�i5������ ���5 .�,r7,ilt� `�� (C,�iilYi � �� l-.�i=��-i�,F; i�C � 1� �, <br />� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn X Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures Show Number (#) of fixtures <br />A/C — air handling units Toilet <br />Forced air systems Bathtub <br />I Gas piping Lavatory (wash basin) <br />Water heater Shower <br />Gas fireplace Kitchen sink & disposal <br />Gas range Dishwasher <br />Clothes dr er Clothes washer <br />Range hood ' Water heater <br />' Exhaust fan ' Sink (service/bar/mop/etc.) <br />' Heat pump Backflow preventer <br />Unit heater ' Urinal <br />Boiler ' Drinking Fountain <br />Refrigeration Floor drain <br />Woodstove ' Grease trap <br />1 Ducting Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM ' Other: <br />Number of Heads Other: <br />I hereby certify that I have read and examined this applicalion and know the same to be true antl correct. Ail provisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or noL The yranting of a permil does not presume to give authority to violate or cancel the provfsion of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perfonn �he work for which application is made and I comply with Bie Stafe Coniractors Law 1827 RCW and 296200A WAC. � <br />_� <br />7 +;�� ��-�• \ <br />,;� . ��� ,� ;i�/� � �� - �,�-��-� ��y ,, �Oz�� <br />Ow erlAu ri� d Agent Signature Date (Revised 6/2012) � <br />`' . <br />