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_ <br /> � cRMIT APPLICATl01� <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� ' a s`�I <br /> r ROPERTYTA%p P M t <br /> � - s � u. ✓ osso oo�vv � ti , = � D� <br /> LEGAL for new construction: Short PlaVsubdivision Lot No._ (attach copy of long lege'desuiption) <br /> OWNER /1 c�N �J� � € PhonelE-mail j' ��j – 7(p0 ' 'r�p, <br /> Address �'JZ (� � C(�,�,� �'{'�j Clty/S1ale2iP Y � <br /> CONTRACTOR � L 8 I Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT I/�.��NE P�L� <br /> � �� <br /> Phane/E-mail 2�� � � GL�� �/��/'�L, (� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (� �z� <br /> Existing Usa of Building ' 6 � HEAT SOURCE: <br /> Proposed Use of Bujlding '�J� ' arn i c,� �L C�i Gas Elearic_ Olher <br /> Building type: �Single Family�—Duplex_Townhouse _Multi-family _Commercial <br /> Type of project: _New _✓Addltion _Remodel ✓�epair_T.I. Slgn_Sprinkler_Demolltlon_Change o(Use <br /> DeSCriplion of WO�Ic(edditionalspace providedon fhe 6ack�: S <br /> �-S l.�t(�C i � `��Gl./L�� � _ � . <br /> " �/ e <br /> Have you staKed working without a permit? _YES _NO q i - � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERIVIIT APPLICATION <br /> TypeofProjoct: _Naw_Addn _Altaration_Ropair TypaolProjocl: _New_Addn _Altentlon_Ropair <br /> Show Numbor(pJ o/lixtures Show Number(p)o/flaturcs <br /> A/C–air handling units Toiiet <br /> Forced air s stems Bathtub <br /> Gas piping Lavato (wash basin) <br /> Water heater Shower <br /> Gas fre tace Kitchen sink 8 disposal <br /> Gasrange Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(service/baqmop/etc.) <br /> Heat pump 8ack(low preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refri eration Floordrain <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medlcal Gas <br /> SPRINKLER / SUPPRESSION SYSTEM _ Other <br /> Number ol Hcads <br /> I hereby ceAi')lhat I have read and ezaminad this appli�tion and know Ihe samo to be true and corrad.All pmvisions of Iaws end ordinances goveming <br /> this lype of woifc will be complied with whether spedfied herein or noL The granOng of a parmit does nol presume lo giva authority�o violale or cancel <br /> the provision ol any other slate or local law ragulaling constrvction or lhe peAormance of construqion.Thet I am aulhorized by Ihe owner of this property <br /> �o peAom.!ho work ior which appliwtion is made and I compty with Ihe State Comractors Law 18.27 RCW and 2�J6.200 WAC <br /> �l(�ZE'����� � ' ���'� Z�l� <br /> OwnerlAuthorizod Agont Slgnnturc Date (Revised 1?QOfO) <br /> /� <br /> 1 <br />