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l ( <br /> . . . PERMIT AF'PLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Sl., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDR�S: Q ,/�, °HOPERiYTA%N PERMITA _ <br /> �hV I (i <br /> LEGAL lor new construcUore Shon PlaVsubdivision Lot No.__ (attach copy of long Iegai descriplion) <br /> OWNER � ( �lC,� (..�-�1,., PhonelE•mail <br /> Address ��( � � ��� T�V'(��� G��U CitylStalelZip � t�y�'(',f�� ' <br /> CUNTRACTOR M(. � C1•\S L 8 I Lic.# '� 'L C./�- <br /> � ��.7�C Phone/Email �-/Z /(f�'3J � <br /> Addmss ' '1 2�'�" �`"� <br /> 7ENANT BUSINE S NAME CONTACT FOR PER�IT <br /> -17�xu.�e.5ri � <br /> �( L'�\�� Phone mail �L. }i �{' �Clt �i. i ' .� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�L�(S-- — <br /> Existing Use of Building__ ___ _— HEAT SOURCE: <br /> Proposed Use oF Building__________ Gas____ Electric____ Other__ _ <br /> Building type: __Single Family _Dupiex_Townhouse _Multi-Fam,/ily _Commercial <br /> Type of project: _New __Addition _Remode� __Repair_T.I.,p,�Sign_Spnnkler_Demolition__Change o(Use <br /> DesCription o(Work(additional spaca provided on fho back): <br /> �e ��e�� ��-�_,—I i�h+� <br /> Have you started working wilhout a permit7 ___YES � NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJeat: _ _New___Addn __ Alleratlon__ Repair Typa o(Project: ___New_ Addn __Alteradon_Repalr <br /> Show Number(pJ ol/lrtures Show Number(N)o/flxfures <br /> WC-airhandlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas pi in Lavato wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clolhes washer <br /> Ran e hood Water heater <br /> Ezhaustfan Sink servicelbar/mop/etc. <br /> Heat ump Backflow revenler <br /> Unil heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove � Greasetra <br /> �uctin Root dreins <br /> Other_______________ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Olher: <br /> Number of Heads Other: <br /> I hereby certily Ihal I M1ave read and examined this appli�3lion and know lho same to be true and conect.All provisions of�avrs and ordinances governino <br /> this tyoe ol vrork will be complied wilh vfiether specified herein or not.The granting o1 a permit does not presume lo give authority to violate or cancel <br /> Ihe provision of any olher s�ale or local law regulaling construction or the performance of conslruction.That I am authorized by the owner ol this property <br /> to peAo he work for which application is made and I comply with the State Contractors Law 78.27 RCW and 296200 WAC ' / <br /> / � <br /> Owned thorizedABentSlgnature � Date (Revised?/2071� <br />