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PERMIT APPLICATION <br />BUILDING!MECHANICAL!PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-6810 — FAX 425-257-8857 — vAatv.everettvva.org <br />nr�n �onu u AM Tn d PM <br />APPLiCAIiON3 nnr_............ <br />- _ -- _ <br />PERMIT# <br />SITEA DRESS: ,�J PROPERTY <br />0 �%� i1/���% /"x/PGG Oi 4 <br />TAX <br />U <br />LEGAL for new, construction Short Plat/subd,vis,on Lot No_ (attach copy of long legal descrip5on) <br />Phone/E-mail %'¢ Z%7y� <br />OWNER <br />'�, OLj /Vil�l'✓/F City/State/Zip i¢ l�//l� %/I i / <br />Address �S yrfi'`J% <br />CONTRACTOR O O L R I Lic. # <br />Phone/Email <br />Address <br />TENANT BUSINESS NAME / ��f CONTACT 3FOR PERMIT ".--7/9 (',�,7V 0X1 - <br />BUILDING i.'ERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Uc to Rullding _/�T�/ (' HEAT SOURCE: <br />Propesso, aecf Building /QL`T�iC. Gas_ Electric__, Goer__ <br />Building type: _ Single Family _Duplex _Townhouse —Multi-Family — Commercial <br />✓T.I. Demolition- Change of Use <br />Type of project: _ New _ Addition _ Remodel _ Repair _Sign _Sprinkler <br />Description of Work (additional space provided on the back) : <br />%j[//GO/NLj� fiGG`',"f-'!G/91 L/ /1ft"L'�/-I/�i�//c�/� � ��G•'"�G//�C7 <br />/NYC�ILIO� ,�s+�t0/,fEty <br />✓ <br />Have you started working without a permit? _YES NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />_Alteration_Repair <br />Type of ProjecC _New_Addn <br />_,Alteration_Repair <br />_New <br />M) of fixtures <br />Show <br />NumberW of fixfuras <br />- air handling units <br />Toiletrced <br />air systems <br />Bathtub <br />Lavatory (wash basin) <br />s piping <br />Shower <br />ter healer <br />Kitchen sink8 disposal <br />s fireplace <br />Dishwasherothes <br />s range <br />Clotheswasher <br />dryer <br />MDucting <br />Water heate• <br />nge hood <br />haust fan <br />Backflow preventerl <br />venterat <br />pump <br />Urinal <br />heater <br />Drinking Fountain <br />iler <br />frigeration <br />Floor drain <br />oodstovo <br />Grease trap <br />Roof drains <br />cting <br />Other <br />Medical Gas <br />other: <br />- <br />SPRINKLER I SUPPRESSION SYSTEM <br />a <br />Other: <br />Number of Heads <br />or�P• <br />I hereby certify that I have read and examined this applica•ion and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The gran'ing of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property V� <br />perform he work which application is made and I comply wuh the State Contractors Lew 18.27 RCW and 29S 200 WAC <br />l I N <br />Owner/Authorized Agen Slgnat Date (Revised <br />Jr'1 JyIaNTv Yr� N b- <br />e <br />