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�, <br /> PERMIT APPLICATION <br /> BUILDIN��IMECHANICAUPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SEFiVICE3 <br /> 3200 C�sdar St., Everelt, WA 98201 -425-257-8810—FAX 425-257-8857—wvuw.everet a.o <br /> APPLICAT�ONS ARE ACCEPTED FROM 8 AM TO 1 PM �� <br /> SITEADDRESB:r � P ,$�,u L PROVfRTYTA%N PERMIT�//0� . OI <br /> �JID �.C/rSi�lo 1��. E. V �� <br /> LE6AL lot naw conaWdlon�. Short PlaVeubdivielon_ <br /> Lol No.._ (altech copy ol lorp lopel deecrlplion) <br /> n Phona/E-meit UZS-2 -IrS/ S/ 7 �.AoL � <br /> OWNER '7 L i `�1d s.lL ' <br /> AUdf86D i �;T,.iE �,JA `1C Clly/Slele2ip /h!M sviLcE �✓ �'2 <br /> CONTRACTOR 4 L&I I.Ic.N <br /> Addrees 5atitq G �(ju UE PhonelF��uell <br /> CONTACT FOR�cRM�1T L cV1 <br /> TENA T BU8I�NlESS NAME 'K �• 1�'lS - �1; —��$6 <br /> � f k'�!�i.�cc- h'7A�RKE PhonelF-m•', 7LS�13L-/SS SiN( /57� �'Ao��� <br /> BUILDING PERMIT pPPLICATION CON*�<ACT Palce oF WORK /D,S�� •� <br /> HEAT SOURCE: <br /> E�isbng Use ol Building <br /> Ge6 Elecldc Olher <br /> Proposed Use ol Building_ <br /> Building lype: _Single Femily _Duplex_Townhouse _Mulli•Femily �Commercial <br /> Type ol project: �New _Aadition _Remodel _Repair_T.L_Sign_Sp�inkler_Demolition_.,Chenge ol Uee <br /> DescnpAon o(Work(eddifionel spece provided on fhe beck): `�3� �i5/�N4 S�e: /> ��- �' S� <br /> I �ULI��L [WC4 V�l1"1P'R.�I� � <br /> Heve you aterted working wlthout a permil7 ,_.YES �( NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PBRMIY APPLICATION <br /> Type ol ProJecl: _New_Addn _Altenllon_Rope�r Typs of ProJscl: _Naw_Addn _Allention_R�p�lr <br /> S�uw Numbsr(M)olllxfurea Show Numbsi /ol flrfuror <br /> A/C-eir handlin units Toilel <br /> Forced a,r s s�ems Balhlub <br /> Leveto wesh basin <br /> Gas i in Shower <br /> Weter heater Kitchen aink 8 dis osal <br /> Gas fireplace Diahwesher <br /> Gas ran e Clolhes wesher <br /> Clothee d er Weter heater <br /> Ran e haod <br /> Exhausl fan Sink servicelberlmo lelc. <br /> Backllow reventer <br /> Heat um Urinel <br /> Unit heater Drinkin Fountein <br /> Boiler <br /> Floor drain <br /> Refri eralion Grease tre <br /> Woodstove R�f dreins <br /> Ductin <br /> Other <br /> Medical Ges <br /> SPRINKLER 1 SUPpRESS10N SYSTEM oiner: _ <br /> Number o(Heads Olher: <br /> I here6y ceAily Ihel I have reed and e��minetl ihis eppllcallan end know Ihe eame to be inie end wrtect.All provielone ol Iewe erd ordinence�povemirp <br /> Ihis type ol vrork wlll be complied wilh vmelher epecified herein or noL The�rarllnq ol e permit doet not presume to plve eulhortly to violete or uaancel <br /> ihe provleion oi any olher sleta or local law reguleling conslruction or the pedonnence ol consirudlon.Thal I em euthorizad by�he owner ol lhle properry <br /> to perlorm Ihe work lor whlch application le mede end 1 comply wllh Ihe Stale Cantreciore Lew 1 B27 RCW end 29b_Y00 WAC <br /> ��L�,;` ,. 2�/3��/1 _ (Revisx0 7/t01 f) I/ <br /> OwnarlAulhorized qant 91pn�tun Dete � <br />