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. � c <br /> PERMIT APPLi:.°ATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> �1��'1 APPLICATIONS ARE ACCEPTED FROM 8 AM T0 4 PM � --�3'-'IZ. <br /> SITEADDRESS: PROPERT/TA%N P MIT <br /> � "3 V Y'�.Cv� �f�(. 00 �$I�Cc�Doo (o Z <br /> LEGAL lor new construction: ShoA PlaVsubdivision Lol No._ (attach wpy o1 lo�g Iege�descnption) <br /> OWNER �50.l�OV �Cti�'G� �jGV � � SSGC.. PhonelE-mail <br /> Address �p s� l��'��i� �2�u Ci�ylState2ip $.eat-I f e q Si I��d <br /> CONTRACTOR ��(tit'�I- '6C NS L81Lic.# GI�{� (Z151 �1?'713n <br /> Adtlress ��C yv�: ��" � PhonelEmeil TZS `1'15 S � �U l7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMI�f <br /> �, (7c�� �n �-recv� <br /> f ' MObJ� �� PhonelE-mail �ti o N C lar � �- S � ✓�S • 1.o✓n <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `-{-�an o <br /> Exisliny Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eleclric_ Other <br /> Building type: _Single Family _Duplex_Tawnhouse _Mulli-Family �,Commercial <br /> Typeofprojecl: __New _P.ddition _Remodel _Repair_T.I�Sign_Sprinkler_Demolition_Change ofUse <br /> Desuiption of Work(eddifionel spece provided on fhe beck/: <br /> lhS}al� (� � �luv�ni�n"C-�d W<<(1 Sl��jh <br /> Have you started working without a permit? _YES `�NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype ot Project: _New_Addn _Alleration_Repair Typa ot ProJeet: _New_Addn _Alterotion_Repair <br /> SM1ow Number(A'/o!fixtures Show Number(#)o/fixtures <br /> AIC—airhandlin units Toilel <br /> Forced air s stems Bathtub <br /> Gas ipin Lavato (wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhausltan Sink senricelbadmo /elc. <br /> Heat um BackFlow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eretion Floor drain <br /> Woodslove Grease tre <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> 1 hereby certity that I heve read and ezamined lhis applicalion and know Ihe same to be irue end cortect.All provisions ol lev.s and orclinances goveming <br /> this type of work will be wmplied wilh whether specified herein or not.The granting ol a permit does not presume lo giva aulhonty to violate or cencel <br /> the provision of any other slate or local law regulaling conslruction or ihe perfortnance of canstruction.That I am eulhorized by lhe owner ol this property <br /> to perlo lhe� epplication is made and I comply wilh Ihe Slale Coniractore Lew 18.27 RCW end 296.200 WAC <br /> i <br /> �"J'�-�Z <br /> OwnerlAuthorized Agent Ignature Date lRevised?J2071J / <br /> �Vv <br />