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� ERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 -425-257-8810— FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , I / PROPERTY TA% P MIT# <br /> � w� � � ` �� <br /> LEGAL for new consWction: Short PlaVsubdivision Lot No._ (altach copy of long legal descnption) <br /> ` OVl'NER `�f ,. 9 � / ' . ��� PhonelE-mail � 7� • � ] <br /> � Address � j �t�.�'/� I:�l City/StatelZip <br /> CONTRACTO � �� � !`-�-L� L 8 I Lic.# <br /> Address Phone/Email <br /> TENA BUSINESS NAME CONTACT FQR PERMIT <br /> / � � ���� <br /> x PhonaGmail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> E;.isting Use of Building S/� HEAT SOURCE: <br /> Proposed Use o(Building `� Gas_ Electric__ Other_ <br /> 6uilding type: 1/Single Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of proJect: _New _Addition ✓Remodel _Repair_T.I._Sign_Sprinkler_Demolitfon_Change of Use <br /> DeSCrip�ionofWork(addRionalspacep�ovidedonfheUackJ: A.� C� ,N Su�/Ji'LC- <br /> ��irloJC �'r'� Ll ' ��,��/';%c �_ , n� ,� <br /> �/ �e � /J hv�n .�L��:.� �•� /Z- G�'^�� � �t. .n3p-.�c f�v� <br /> r .v,: ac.0 i�` ., � <br /> Hav�ybu started working wilho��t a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypo of ProJect: _Nuw_Addn _Alteration_Ropair Typo of ProJact: _Now_Addn _Altaration_Ropair <br /> Show Numbcr(a)o!lixtares Show Num6er(N)o!/ixNres <br /> NC-air handliny unils � Toilet <br /> Forced air sys�ems _ I Balhtub <br /> Gas piping _ Lavatory(wash basin) <br /> Water healer � Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gas renge _ Dishwash�r <br /> Clolhes dryer Clolhes washer <br /> Range hood Water heater <br /> Exhaust(an Sink(service/bar/mop/etc.) <br /> Hea�pump � [3ack(low preventer <br /> � Unit healer _ � Urinal <br /> Boiler Drinking Founlain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ I Other <br /> Number of Heads <br /> I hereby certity that I have read and eaamined ihis applicallon and know lhe same to be Ime and co«ecL All pmvisions of laws and ordinances goveming <br /> Ihis type of work will 6e complied wilh whelher,pecifed herein or not Tho granting of a permit does not presume to give au�hority lo vialate cr cancel <br /> Ihe pmvision of 2ny olher slole or local law mgulating constmclion or Ihe per(ormance of conslruction.That I am aulhorizctl e�y I�:e e;:ner ol thi;Froperty <br /> to peAorm�he work for wh� h applicalion's mad�an compty with Oi=Slate Con�ractors Law 1327 RCW and 296.200 6YnC <br /> � / <br /> � , J <br /> wnerlAut rizodA8unt51gnatur � Date f�Q � l"='��_`� ��-=���1 <br /> ' �1S`� <br /> sys� <br />