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c ,_ <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBIN;/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 I�/O "�� <br /> SITEADD S:n SOh P� PROPERTYTA%N PE�2�/ — OD <br /> V <br /> LEGAL lor new onstraction: Short PleVsubdivislon Lot No._ (allach co:�y of long legal descriptlon) <br /> O�;�NER � (�7 � PhonelE-maii 20 �7 SJ'� �Z O Z <br /> !.ddress QQ(1"1 y KQ„ � CitylSlale2lP Qq�{FC �,�/,1� -1 ��� <br /> CONTRACTOR Qq (Q 1 L 8�Lic.# SE���FG R S <br /> Address S Z� � `S'� �W OG I p �S� PhonefEmail 2 06 —�c sd —6 I 3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 6 I3 ! <br /> Zv6.vS�- vr, <br /> �� � PhonelE-meil n /Q S4(e <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �l'i(�• do <br /> Existing Use o(8uiiding HEAT SOURCE: <br /> Proposed Use o(Building Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex Townhouse _Multi•Family _Commercial <br /> Type of projecl: _New Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change oi Use <br /> DescriptionofWork(edditionalspaceprovidedonfhebeck): 2��/.� II�Q�Q,Q �Q,� uerdron '�(� QQ(�q� <br /> o f livin'sPrt.c� J U � <br /> Have you started working without a pertnit7 _YES Y NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot ProJeet: _New_Addn _Alteration_Repair Type of Projecl: _New_Add� _Altention_Ropair <br /> Show Number(MJ o1�xtures Show Number(M)01/lirturos <br /> PJC—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas pi in 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 /> Range hood Water heater <br /> Exhaust tan � Sink servicelbarlmopletc.) <br /> Heat pump Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> I hereby certiy Ihal I have read and examined Ihis application and know the same to be true and cortecl.All provisions of laws and ardinances goveming <br /> this lype of work will be camplietl wilh whelher specifed herein or nol.The granting of e permit does nol presume lo give authority to vioiate or cancel <br /> ihe provision ol any other slale or local law mgulating consiruction or lhe performance of construction.Thal l am authorized 6y lhe owner ol lhis propeAy � <br /> to perlor"�Ihe wo lor whlch applic o is made and I comply with the State Contractois Law 18.27 RCW and 296.200 WAC <br /> \ bl � lo �1,012 <br /> OwnerlAuthorized Agent Slgnature Da (Revised 220f iJ <br />