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l <br /> PERMiT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/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 /> pPPLYCAT10N3 ARE ACCEPTED FROM 8 AM TO 4 PM �'�7 �' <br /> SITE ADDRESS: VROPEn7Y TAX a RMI7 t <br /> '!3 O� 0 'O - <br /> LEGAL tor new cons�ruction� Short PlaUsubdivislon Lol No._ (etlach copy ol lonp lepal descriplion) <br /> OWNER �� / l' Phone/E•meil (o- � <br /> Address 7 �v CitylSlate/Zip • / �. <br /> CONTRACTOR L 8 I Lic.# <br /> Address Phone/Emeil <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT . -« <br /> OGR�+�rQ �Qv�Xn��. n�� <br /> Phone/E-mail L <br /> BUILdING PERMIT APPLICATION coNTRAcr rRlce oF WORK <br /> Existing Use of Buiiding �-a. n.� � l�oo.n HEAT SOURCE: <br /> Proposed Use of Building � - - ��•� ,c on r� Gas Electric Olher <br /> Building type: ,�[Single family _Duplex_Townhouse __Multi-Family _Commercial <br /> Type of project: _,New _Addition _Remodet ,�Repair_T.I._Sign_Sprinkler_Demolition_,Change ot Use <br /> DescriptionofWoflc(ed0itionalspaceprovidedonthaback): n�k`t �����- ���0��'S �r �„�oLhfap.n <br /> (�r�� !n1 �" /� 11 I / / I� <br /> �.tf/c�`I KooT � •1 vn /�les.'1'.✓ wc<a <br /> I <br /> Have you atarted working wilhout a permil? �YES _NO <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaolProJact: _New_Addn _Altaratlon_Repalr TypeotProJect: _New_Addn _Alhntlon_Rep�lr <br /> Show Number(MJ o/�irfurea Show NumDer(/)01 flxturos <br /> A/C-air handlin units Toilel <br /> Forcedairs stems ' �-.) Bathtub <br /> Gas pi in Laveto wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink S dis osal <br /> Gasran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water healer <br /> Exhaust fan Sink(servicelbar/mo /etc.) <br /> Heat um BackBow reventer <br /> Unit heater Urinal _ <br /> Boiler Drinkina 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 here6y ceitify that I have read and examined ihis application and know�he seme to be irue and corteq.All provisions ol iaws end ordinen goveming <br /> this type ol work will be complied with whether specified herein or�ot.The granting ol a permil does not presume to give authority lo vlolate or wncel <br /> th ovision of any o�her state r local law regulating conslruction or the performance al consliuctlon.Thal I am aut�orized by the owner ollhis property <br /> o peA m Ihe wor o ich plicallon is made and I comply with Ihe Sla�e Contractors Law 18.27 RCW and 296.200 WAC <br /> narlAutho zedAg tSignature Dale (Revisedl/20f7) <br />