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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/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 />.rime ARE ACCEPTED FRnM R AM TO 4 PM '? — it —it <br />SITE ADDRESS;_ ` <br />PROPERTY TAX II <br />PARMIT11 <br />1 Ins -0DI <br />��7 <br />LEGAL for new construction: Short PlaUsubdivision Lot No __ (attach copy of long legal description) <br />OWNER O <br />Phone/E-mail <br />Address 5 f'V rn F <br />CitylSlalelZip <br />CONTRACTOR 1t C Iff L & I Lic. # ' <br />Address PhonelEmail� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />PhonelE-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Existing Use of Building _ <br />Proposed Use of Building Gas_ Electric_ Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />_ <br />Type of project _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition,_,Change of Use <br />Description of Work (additional sp ce provided on the back): C -„/) Oq �O7 <br />� FINS(-t (J�/l <br />�o <br />Have you started working without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICAT;ON <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Type of Project: _Now _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Slow Number (#) of fixtures <br />A/C — airhandlingunits <br />I Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes of er <br />Clothes washer <br />Range hood <br />I Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heal pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinxing Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />Other: <br />SPRINKLER ( SUPPRESSION SYSTEM <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this typo of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other slate or local law regulating construction or the performance of construction. That I am authorized by the owner of .his property <br />to pe orm the wo'h for which applicatlo�made and I comply wi the Sc(Revised 2R011J <br />State Contractors Law 18.27 RCW and 298.200 W.4C <br />Ownar/Authodzod Agent signature /p Dale <br />