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. u����1,=�-- <br /> PERMIT APPLICATION �� ��� <br /> BUILDINGIMECHANICALlPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar 5t., Everelt, WA 98201 -425-257-8810—FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TA%N PERM�T# <br /> yd�i - y835 �/ERUR-C[�l wAY , tl/E� Wn �d,5E�9�dc�O�ld/ 1 i � <br /> LEGAL for new constmclion: ShoA PlaVsubdivision Lol No._ (altach copy of lon�legal description) <br /> OWNER lSA[X'R SGNRfl6ER a- AS�u '�'S ��G Phone/E�mail �5, 259, 25}I <br /> Address (o$� Ol2G<�5 S7R Cily/S�aie/Zip $Rf]TLC l�✓A gPi/O� <br /> CONTRACTOR Mrn�n�o✓� ����n�s 1u�• �ai �ic.x MtRfnBT�2�NIC <br /> Address (�$(,5 ��DODLAwnI AWJUE �E A110 , `� GE �✓li 9EIl� Phone/Email 2�G. �E6.ygGo <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> f'oef'RT �RU� /�PIEt,E E7l�y�NCt]�-'S rue. <br /> ptE}IAM1DWP�6 Auf�2N4t��NR��S � WI�D ('ir�9�iuuClri7rpd9� PhonME-mail 92S.BZE.y2vox22L �Pj�CDlB ��+w�S. aih <br /> �1'H 5T' D�A-C P.l� .Cb noi e 41 <br /> SUILDING PERMIT APPLICATION CON7RACT PRICE OF WORK �IS� coG <br /> Existing Use of Building n�N!'�l��a� HEAT SOURCE: <br /> Proposed Use of Building :cNn(12eia� Gas_ Electric_ Olher_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �,Commercial <br /> Type of project: _New _Addition K Remodel x Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> Descriplion of Work(addifional spacoprovided on fhe back): <br /> REPhi2 A,vD Rc��ra�cZ JF �'�ST�,vc� FQCJA N�vD PnfUrPLTs 'TD 5+��+itA2 PRofiGS �n•D Fa.�n2t1F5. <br /> �k15T/•vG� 1b�+�aGEA co��.FuuniE�✓f� Ta f3E �b'PA/R�� f�EPGALb'P � aR 'fQE+�h—D Fl�� NEt�P. <br /> Have you slarled workfng without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERM1IIT APPLICATION <br /> TypoofPro)oct: _Naw_Addn _Altaration_Ropair TypoolProJocl: _Now_Addn _Alloratlon_Ropair <br /> SNow Num6cr(N)o(lixfures Show Numbcr(N)of lizf�res <br /> � A!C—air handling units � Toilet <br /> � Forced air systems 8athtub <br /> � Gas piping � Lavatory pvash hasiN <br /> � Water heater � Shower <br /> � Gas freplace Kitchen sink 8 disposal <br /> � Gas range Dishwasher <br /> � Clothes dryer � Clothes vresher <br /> � Range hood I Waler heater <br /> Exhaus�fan - Sink(service/badmop/elc.) <br /> Heal pump BackOow prevenler <br /> � Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trep <br /> Ducling Roof drains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Numberof Heads I Other. <br /> 1 hereby certify Ihal I have read and ezamined Iliis application and know Ihe saino to bo Iruo and corcecl.All pravisions ol laws and ordinances goveming <br /> Ihis typo of work wili 6e complied�vith whefher specified herein or noL Tho grantine�ol a pemiit does not presume to give aulhority lo violate or cancel <br /> Ihe pmvision ol any olher state or local law m9ulating conslruclion or the pedormance ol conslNclion.That I am aulhorized by the mvner of Ihis property <br /> to perlorm the woik lorwhlch application is made and 1 comply�vith tho Stato Conlraclors Laei 18.27 RCW and 2962W WAC <br /> ll � ��adll <br /> OwnorlAuthorimd A�ent Slpnaturo Da o (RavisedY1017) � <br /> �� <br />