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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, N/A 98201 425-257-8610 FAX 425-257-8857 www.evereriwa.org . <br /> SITE ADDRESS: PROPERiV TAX p P T <br /> o `uU . 03 � - DO <br /> LEGAL for new construelion: ShoA PlaVsubdivision Lo!No._ (atlach copy of long legal tlescripllon) <br /> OWNER PhonelE-mail <br /> A00ress CitylSlete2ip <br /> APPUCANT: Owner OwnefsApenl �.Contractor ConlracLrsAgeat TenaNp,wsipromaaisnnamnu,xaommaowneradowemmuro:Pxe� <br /> CONTRACTOR � �� CGT � . yState Lic.# B F PSCc.� �z9 ,nA c�� Bus. Lic.# <br /> AAdress �J D� ���� C7f�A1 ���s W�/ qU �S� PhonUEmail 7 W �.30b��Z••� �, : e. o.M <br /> TEN NT BU INESS NAME CON7ACT FOR PERMIT <br /> �I I AC� $o�M PhonelE-mail �,��� y� Z3—I ' (J� "1 0 <br /> BUILDIN{G PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exisling Use of 6uilding L HEAT SOURCE: <br /> Proposed Use o/Building 1Z'47�4n�`� Gas__ EMclrtc_ Other_ <br /> 8uilding lype: _Sirgle Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> T e of project: _New _Addition _Remodel _Repair_T.I. Sign_Sprinkler_Demolition_Change of Use <br /> DESC IPTION OF WORK(addifional spaceprovidedon IAq back): <br /> A�� �7 nre.W SQ�,^kler �ee.c� s �co�M �et�i s�inS sys�.�^'� . <br /> MECNANICAL PERMIT APPUCA �)N PLUMBING PERMIT APPLICATION <br /> iype of Pro)act: _New_Addn _Alteration_Repatr Typa of PraJect: _New_Addn _Altentlon_Repalr <br /> Show Number(N)olllxfures Show Number(MJ o//ixfures <br /> A/C—air handling unils � Toilet <br /> � Forced air systems Bathtub <br /> Gas ipin Lavato wash basin) <br /> • Water beater Shower <br /> Gas fire Isce Kitchen sink 8 dis osal <br /> Gas renge Dishwasher <br /> � Clothes d er � Clothes washer <br /> Ran e hood Waler heater <br /> � Exhaust fan Sink service/bar/mo /etc.) <br /> Heat um BackFlow revenler <br /> � Unit heater llrinal <br /> Boiler Drinkin founlain <br /> Refrigeration Floor drain <br /> Waadstove I Greasetra • <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> � Number of Heads Other: <br /> I�ereby certily Ihat I have rad and ecamined IMa epplkation antl know IM same to be Irue and wrrecl.All provisions ol lavs and oMlnances goveming IMs type of work wdl ba compGed <br /> wilh whel�er spectlled�erein o�noL TAe granlhp al�pertnA aces not presume lo give auNonty lo vlolale w cencel I�a provislon ol eny other slalo or bcal law nquWling canslnrcibn <br /> Thal I am aulh«IxeA hy the ovmer W Ub prope�y V pertorm Na work lof wAkh epplkation Is matle and I canDly wAh Ihe Slale Contracloro Lax 1B.21 RCW antl 298.ZOOA WAC. <br /> �� r� Qf.Ps. c:�c, ��3���/�/ ._ . <br />