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� <br />� <br />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 />SITE ADDRESS: 1 � �� / IPROPERTY TAX # I P�/ /� IT # <br />��1 � G� P i �I C J/. �l A� t (.i%/" I V l� r7 �.' e� __ <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER <br />LICANT: _ Owner _ Owner's Agent <br />NTRACTOR ��, (� �1� r nc � <br />ress i(�ti 1��c x��I S S� l�/I <br />JANT BUSINESS NAME <br />C C>c co :� f�e :cSe <br />Phone/E-mail <br />City/State/Zip <br />_ Contractor _ Contractor�S A9@flt _ T2f18f1t (must provide a letter of consent from the owner to do work in the space) <br />g, L/J c y�i�� M <br />c i; n f• t•�:,, , State Lic. #. � 1} �5 9/z p j� City Bus. Lic. #�C-'��C� <br />� � • � },n Icinr �; � �. <br />� . I ( . (,c.� �- `��D � 7L} Phone/Email �jLS S ��OI2�/ sc, -!�Scri <br />CONTACT FOR PERMIT /� �� �� � ,�./ :� .� �L�y�y <br />Jct v�rv� M���,r 3<. /.' <br />Phone/E-mail �/ZS� S�� v% Z�/ . j�� •^, P s�� h� la �c r° -. <br />.a <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `� fG a`�J <br />Existing Use of Building � n e��-r/ HEAT SOURCE: <br />Proposed Use of Building n=L _ I I1 � w��{ p �., j� c� �,_;/��� '> Gas� Eiectric_ Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />�pe of project: fVew Addition Remodel Repa Z_ T.I. Siqn Sprinkler Demolition Change of Use <br />�� <br />DESCRIPTION OF WORK (additional space provided on the back) : w �t �-�•' � e'L `���" <br />, c, ;� i t, ., k'e� � <br />� i G � 2� �- Jr��-�- �} I �� bfu <br />� � w10 J� t'�-; �: � / � IC � � r� � ] `.- <br />� ��,� w��� �� �� �vr�-r z,o.� �v�,�:Y�, ��,� J; ��s s ��� y- crG,�.,� i <br />I� c�� Z C C t��s' <<[c �r�. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn f Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ranqe <br />Range hood <br />Exhaustfan <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby cerlify that I have read and examined this application and know the same to be lrue and correct. All provisions of laws and ordinances governing this type of work will be compl <br />with wh ther 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 a authorized by the ow of this property to pertorm the work forwhich application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />`�2��, ��'� <br />� )�- )� -��'' <br />Ow /Authorized Agent Signature Date (Revised 9/2014) <br />F- � i�'J r <��s'-c;� <br />r� SC��✓ �CQ), <br />G'U :� <br />