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� '. <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> ChTY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-861U—FAX 425-257-6857—www.everettwa.org <br /> APPLICATICNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SfTE ADDRESS: PROPER7Y TAX p PEfjM1T# <br /> / v e.� Gu � �- S <br /> LEGAL(or new constrvdion: S�orl PlaUsubdlvision Lot No._ (attach wpy of lonp lepal descriptlon) <br /> OWNER Phone/E-mail <br /> ddress CltylSlatelZip <br /> CONTRACTOR E���� �� L�C L 81 Lir.# E�s�F.Y/�1FG 96otil2 <br /> ddress �/O�' 1 �iLA�ME�( f-�-� 1=P� �� • � A�lAO[ r�S�j •LOL '/Z�J <br /> Phone/Email [ ! / � <br /> TEN��S yESS NA��� CONT��T FOR PERMIT G'il/.?S3-��^/Z�7 <br /> KE�>1! /�+���/17'�H - <br /> �� L Phone/E-mall ry,V FMF•1G'1LQ�� ��e-G7"+ <br /> BUILDING PERMIT APPLICATION coN7RACT PRICE oF WORK_ <br /> Existing Use of Building t7.��� HEAT SOURCE: <br /> Proposed Use ot Bullding .DE7.'�3/l Sd�ES Gas_ Electnc_ Olher_ <br /> Building typa: _Single Family _Duplex_Townhausa Multi•Family ,�Commercial <br /> Typeofproject: _New _Addition X Remodei _Repair_,T.I.,_Sign_Sprinkler_Demolition_Change otUse <br /> Descriplion of Work(addilional space proWded on fhe back):. . ��A�`/J� /�`��/an�� <br /> �,;� 5p,e..•,cl.-. /l'roAiR'ti+no�. <br /> Have you started working without a permit7 �YES _NO ���O 0�`�f - `�A'� SA�6� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeotProJecl: _New_Adtln _Alteratlon_Repalr TypeofProJect: _New_Addn _Alleratlon_Repalr <br /> Show Number(Ni o/Oxfures Show Number(NJ o/Rxfures <br /> A1C-air handling units Toilet <br /> � Forced air s stems Bathtub <br /> Gas ipin Lavato wash basin <br /> � Waler heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br />� Clothes d er Ciolhes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sir.k(service/bar/mo /etc. <br /> Heal um Backflow reventer <br /> Unil heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> Woodstove Grease lra <br /> Ductin Root drains <br /> � Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> (��� Number of Heads Other: <br /> I hereby certity that I have read and ezamined Ihis application and know�he same to be Irue and correct.All provisions ol laws and ordinances goveming <br /> this rypa ot work will be complied with whether specified herein or not.The grenting ol a permit tices not presume lo give aulhority lo violate or wncel <br /> the provision ol any olher state or local law regulaling construction or lhe pertormance ol consl�uction.That I am authorized by Ihe owner ol lhis properry <br /> to pe�lhe vrork r whi�pp� �ion' matle and I compty wilh t�e Stele CoMractors Law iB.27 ftCW antl 298.200 WAC <br /> [/� �'�7 �� <br /> OwnerlAulhorized Agent Signature Date (Revised?/P017) <br /> �/a <br />