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F'�RMIT APPLICATInN <br /> BUILDINGINIECHANICALIPLUMBINGlSIGNlSPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everett, WA 98201 -425•257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEAI�E� : � i��l PROPERTYTAXq P; MIT� " � <br /> 53 v <br /> LEGAL for new mnslruction: ShoA PlaVsubdivislon _Lot No._ (altach copy of long Iegai descnplicn) <br /> OWNER ��.�Ef � Cftle PhonelF-maii <br /> Atldress b ' ��uC 1�'L City/Slate/Zip � e ¢,"I"1 !'. C z� <br /> CONTRACTOR � ��.e– L&I Lio.# 15i d�–�n <br /> /� �79 � <br /> Addmss t� Ox � l;� �an � �� "10� Z PhonelEma�l uZ.S'3 d`���Z � � .CDh <br /> TENANT BUSINESS NAME CJNTACT FOR PERMIT �ON SMfI�� <br /> ,,�n,�. as �cVe PhonelE�mail 12 -333''-CIZu � Ib�I�G' OI..Lcn <br /> BUILDING PERMIT APPLICATION CON7anCTPRiCEOFwoRK��;�1�'—' <br /> HFAT SOURCE: <br /> Eris�ing Use of Building — <br /> � �u51 Gas Electnc_ Othcr_ <br /> Proposed Use of Building l��A� — <br /> Buildingtype: _SingleFamily _Duptex_Townhouse _Multi-Family �Commercial . <br /> Typeof project: ,LNew _Addilion _Remodel _Repair,_T.I._Sign�Sprinkler,_,Demolition_Change ofUse <br /> DeSaiptlo0 of Work(atltlitional spaco provided on tho backJ: � ��� <br /> �s-i�c.0 ,n�4,� .�-�ud�'un�l. e�jstw .�ntl.cn.�u� ���,uf� <br /> Havo you started workfnp without a permil7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJecL• pNew_Addn _Nhratlon_Repair TypoolProJecl: _New_Addn Alterallon_Repair <br /> Show Number(%1 0//Ir(ures Show Numbc�(kJ ol l�+�wes <br /> NC–airhandlingunits � Toilat <br /> � Forced air s stems � BalhNb <br /> � Gas piping Lavato (wash basin) <br /> � Waterhealer Shov;er <br /> Kitchen sink 8 disposal <br /> � Gaslireptace � Dish�vasher <br /> Gas ran e �I <br /> � Clothesdryer Clotheswasher <br /> � Range hood � Water hea�er <br /> Exhaust fan � Sink(servicelbadmop/elc. <br /> Heat pump � Backflav revenfer <br /> Unil heater � Urinal <br /> 6oiier �rinkin fountain <br /> Refrir,eration Floor drain <br /> � Woodslove Grease trap <br /> � � Duclin ftoof drains <br /> � Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I other. <br /> �� � Number of Heads � Other: <br /> � - <br /> I hereby cerli/y thal I havo read and examined Ihis applica�lon and know iha same to be true and wrrecl.All provisions ol laws and oMinances goveming <br /> Ihis rypo ol work will be complied wilh whxlher specifed herein or not.Tha graNing ol a permit does not pmsume lo Bive auNonty to violate cr wncel <br /> th^_provislon ol any other state or local law regulaling wnslruclion or lha peAormance ol consWction.Thal I am authonzed by the c::ner of Ihis preperty <br /> to peAorm the vrork for which application Is made and 1 wmpy wilh the Stalo Contreclors Law 18.27 RCW and 258.200 VJAC <br /> � \ II <br /> � '�'T1 tr,u(�` �(-(',SLI..0 �P�Z2 12 <br /> Dae (Revised 7R01 t) <br /> Ow'nedAuthodzed A9ent SlgnaWm 7� <br /> /– <br /> / i <br />