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� PERMIT APPLICATICt,�� <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 9820� -425-257-8810—FAX 425-257-8857—www.everettwa.urg <br /> MPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM — �- <br /> SITE ADDRESS: PROPERTY TIU(N PERMIT I <br /> I l02o Pr���E Fi�o wtiY e�eQer wn :���� " <br /> LEGAL for new consiruction: Short PlaVsubdivision�S3�S�N2 �P?�GE}�__Lo�No._�_ (attach topy M lonp legal descnption) <br /> OWNER �z �HES NW 11C Phone/E-mail \4ZSJ 33� 'SS� L <br /> Add�ess P� 6�x 14�IZ'1 CNy/State/Ziv M�� G��K WA Y:.o�� <br /> CONTRACTOR (_o;1rJ=n5-t,f.r NeML-S NeJ LLC LEILie.M C�%RNtHN94� CA <br /> C42S jiY'S::.i: <br /> AEdress Pu Qu> �`�`{Zy �1�u CREEk �.f�4 9`:UtZ PhorrelEmail .��n��;�N„StiN_HariES.uL <br /> TENAN78USINESSNAME CONTACTFORPERMIT Mqn- iMPo�-R <br /> PnonelE-mail l�'lZs�33'�-5555 M�rQc,-RM"�nnr_�i..rneS.uS <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ _ <br /> Existing Use ot Building__ ___ __ HEAT SOURCE: <br /> Proposed Use of Building__,___ ___ Gas_X_ E�ectric____ Other____ <br /> Building lype: X Single Family __Dup�ex_Townhouse __Multi-Family _Commercial <br /> Type of project: _�New __Addition _Remodel _Repair_T.I.__Sign_Sprinkler__Demo�ition_Change of Use <br /> DeSCtiption o(Work(addifional space provided on the back): <br /> �RS�c. �y �3 \PLRN �� b� �sl <br /> Have you atarted workinp without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBINiu PERMIT APPLICAYION <br /> Type of Project: _`,LNew__Addn __ Alteralion___Repalr Type ot Projaet: �New__AOAn _Albntlon__Repelr <br /> Show Number N)ol flrturas Show Num6er I o!flrNn� <br /> A/C-air handlin units 3 Toilet <br /> Forced air s stems 2 Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace I Kitchen sink 3 dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er I Clothes washer <br /> Ran e hood Water heater <br /> y Exhausl fan Sink service/bar/mo lelc. <br /> Heat um BackOow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <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 certily thal I have read and eaamined lhis applicalion and know lhe same to be true and wrtect.All provisions ol laws and wdinances goveminp <br /> Ihis type of work will be complied v+i1h whe�her specified herein or not.The grenting ol a pertnit dces nol presume lo pive aulhority to violale or cancel <br /> Ihe provision ol any olher slale or Iocai law regulating construction or Ihe pedortnance o(construction.That I am euthorized by the ownar ol lhis property � <br /> lo peAorm the work for which application is made and I comply with Ihe Stale Con�raclors Law 1827 RCW and 296.200 WAC � 2 <br /> 'l'11�; �,.,,rP� 8'I 5 �I l <br /> OwnerlAuthorized Apanl Sipnature Dale (R6.ised 2/201 iJ <br />