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� - � �ERMIT APPLICATI�.� <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> MPLICATIONS ARE ACCEPTED FROM S AM T01 PM �-O 7�— <br /> SITEADDRESS: CROPERttTIUflI PER iT� <br /> PAWE FIEtO WFY Ev.RE�� WR :."l <br /> LEGAL tor new construction: Short PlaVsubdivision�5dk5ID E �a�Get Ilt Lol No_S_ (atlach copy W bnp legal description) <br /> OW!�tR ' � �= u�tS NW I.LC Phone/E•mail \y25) 33� -55°G <br /> naare5s Po 8�x 14'12'i City/Slate/Zip M�� C+.�K WA yt��� <br /> CONTRACTOR C.o�nl=us-c, � l-1orti�:.s N�J I.LC L&ILic.fl CC�NtHN94� c � <br /> Cvis s� -s.:.e <br /> Address PU Qu>� ���y2y N\I�� �� WPr 9Y'J�2 Fh0110/Ert18il Hn�Q,iV�Ne.SyN�KoMFS,uS <br /> TENANTbIi�lNE55NAME CONTACTFORPERMIT �„�q� ,r,Po�n <br /> Phone/E-mail ��1Z5�33t-y555 M�rec,:f.N'�nnr_NwneS.uS <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building�___—_—_— -- __ HEAT SOURCE: <br /> Proposed Use o(Building___� Gas_X_ Electdc____ Other____ <br /> Building type: X Single Family __Dup�ex�Townhouse _Multi•Family _Commercial <br /> Type o(project: _�New _ Addition _Remodel __Repair__T.1.__Sign_Sprinkler,Demolition_Change of Use <br /> Descripti0n o(Work(addilional space provided on fhe back): <br /> 6r�s� � � 4i3 (P�,�,� I� �� p) <br /> Have you atarted workinp without a pertnit7 _YES �NO <br /> MECHANIvAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJact: �New__Addn __ Alteratlon___Repair Type ol ProJecl: �New_Addn _AlNntlon__Repair <br /> ShowNumbai M o//Irfums ShowNumbai o/flxtunt <br /> PJC-airhandlin units 3 Toilet <br /> Forced air s stems 2 Balhlub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace � Kitchen sink 8 dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er 1 Clothes washer <br /> Ran e hood Waler heater <br /> y Ezhaust fan Sink service/bar/mo letc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drein <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other_________ Medical Gas <br /> SPRINKLER / SUPPRESSIOH SYSTEM Other: <br /> � Number of Heads Other: <br /> I hereby certily lhal I have read and eKamined ihis application and know Ihe same lo be irue and corteM.fUl provisions ollaws and ordinances gaveming <br /> �his lype ol vrork will be complied with whether specified herein or nol.The granting of a pertnit does nol presume to give authority to violale or cancel <br /> ihe provision ol any olher slale or local law regulaling construdion or the peAormance of conslruction.Thal I am aulhorized Dy lhe rnmer ol this propeAy � <br /> to peAorm Ihe work lor wfiich application is made and I comply with ihe Stale Conlractors Law 7817 RCW and Y96.200 WAC � <br /> A p <br /> 2�1�t�. �.�4s� 0'�5 I�( <br /> OwnerlAulhorixed Agenl Signature Oate (Reviaed 1120f 1J <br />