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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 />ADDRESS: .;M PROPERTY TAX �f PE IT # �- <br />t�,2� I��z �r. �� 2�s��c�y��oc� �"� 3(D � oo= <br />3AL for new construction: Short PlaUsubdivision S{-� QD_� � ��� Lot No. <br />'NER �--�U I�v j�y-� �r0 PN' �S Phone/E-mail <br />ress � C�%� J ��� City/State/Zip � <br />(attach copy of long legal description) <br />�=z���1-2z�y <br />f���� <br />LICANT: _ Ow�er � Owner�S A9Bflt _ COf1lf2CtOf _ COf1if8CtOf S ACJ2flt _ T@IlOflf (must provide a letter of consen� from Ihe owner to do work in the space) <br />0 <br />7� d <br />,� vv� ��yo�S �FI���, v� �j <br />BUILDING PERMIT APPLICATION <br />/ L & I Lic. # ��iU � � � I.k� �✓� COE Bus. Lic. # <br />�2 - z�� Phone/Email `�IZJ� % 7�` ��/�j <br />ll <br />�.,, . ".,.,, , /�.. ,� 1 �r i �SSG�. i�J � <br />t"I �� �,/,� <br />(,/7C� ._�i7L� ._l�; %i1��0 %1P� 1 � i�:..y�.i��i"ll�. <br />c_,� <br />PRICE OF WORK �Z� •GZ%�% <br />� <br />Existing Use of Building �"� HEAT SOURCE: <br />Proposed Use of Building /� Gas_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair � T.I. _ Sign _Sprinkler _Derr <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />i n-h�h �1 -�,_ �-�.�-� + �m �Y o.,�,w�.e-� ���v� 5��-- C T I-tz.� <br />r�s-tv c� w� ,(lt�� wc`�\S ,(���= r-�I ;�� � a-vr C� �.o U`�S , <br />MECHANICAL PERMIT APPLICATION <br />Type 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 />Gas fireplace <br />Clothes dryer <br />Range hood <br />Exhaustfara <br />Heat pump <br />� Unit heater A <br />Boiler <br />Refrigeration <br />W oodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSI <br />Number of Heads <br />olition Chanqe of Use <br />1✓t L 1 v c(s., K,C�� f� <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) oi fixtures <br />Toilet <br />�I� Bathtub <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water hgater <br />Sink (ser0�lce/bar/m <br />Backflow p venter <br />Urinal <br />Drinking Fountai <br />Floor drain <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 rype 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 ihe work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />� � � � <br />,c � -� .,;�. 0 3 �3 <br />Owner/ 'thorized Agent Signature ate (Revised 6/2012) <br />�'�. � � .�„ I <br />