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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMEC! !ANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY UF EVERETT PERMlT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM r `2Z`�� <br /> PROPERN TAX N PERMIT N <br /> SITEADDRESS: Z�V4� Z�U2�U '7'o0 (�� � <br /> �ao� z��'� r�� cJ + <br /> LEGAL for new constiuclion: ShoA PlaUsubdivision �.L'�.Y�d•+ O Z�-�I��VS�t•f 1�Lo1 No.3� (allach copy ol long legal descnplion) 0� R-A� <br /> OWNER �—�F��1� r✓�� a fU,���A^��G PhonelE-mail <br /> Address J City/Slale/Zip <br /> CONTRACTOR �iVT �I���"A�ILAL �G �s i ��c.# �—fN�1M�L�-DI K-1 � Z� <br /> Address �� �11��LT� �`- � � �'��I wA'��Z� Phone/Email<2���`��"ZZ`� �1-wrr�+����cR •�'1`` <br /> TENANT BUSINESS NAME CONTACT FO�PERMlT �hP-c-�S�'� <br /> �/, ff\ <br /> ��� �-/�� Hyy�(�{ I�flr( (.� PhonelE-mail (2�G�/ 7��ZZti'� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �l,8oG <br /> HEAT SOURCE: � <br /> Existing Use of Building <br /> Proposed Use of Building Gas_ Electric_ Olher_ <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project_New ,_Addition _Remodel Repair_T.I._Sign_Sprinkter_Oemelition_Change of Use <br /> Description of Work(addifional spaceprovidedon the baclp:�1 �� ���,� -��L G���iT �N�T <br /> ���-nc� � -���5 P �� u��t <br /> 3'1� �-}vri 5 P=� u w���-r. <br /> Have you started working without a permit7 _YES _NO <br /> CAECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _Now_Addn _Altoretion_Ropair Type of ProJect: __New_Addn _Alteralion_Repair <br /> Show Number(#)o�/ixtures Show Number(q)o/�xtures <br /> � A/C—air handling units_ I Toilet <br /> � Forced air syslems � Bathtub <br /> � Gas pipirg � Lavatory(wash basin) <br /> � Water heater Shower <br /> � Gas fireplace I Kilchen sink&disposal <br /> Gas range Dishwasher <br /> � Clothes dryer Clothes washer <br /> � Range hood <br /> ! Waterheater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump I BackFlow prevenler <br /> � Unit heater � Urinai <br /> � Boiler Drinking Fountain <br /> R2irigeration Floor drain <br /> � UVoodstove Grease Irap <br /> � Ducting Roofdrains <br /> I Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> � Number of Heads I Other: <br /> I hereby ceAify that I have read and examined Ihis application and know the same lo be�rue and correcl.All pmvisions of laws and ordinances governing <br /> this type ol worg vri!ll,t�e complied with whether speci(ed herein or nol.The c�ranting of a permit does nol presume to give aulhority lo viola�e or cancel <br /> Ihe pmvision ora9y other state or local law regulating conslruction or lhe perfermance of constmction.Thal I am au�horized 6y Ihe owner of lhis propehy <br /> to pedorn thej�y6rk for which application is made and I comply wi�h Ihe S�ate Contraclors Law 1827 RCW and 296200 WAC <br /> �/� <br /> /�� f'j/`7j J/ <br /> OwnorlAuthorizad Agont Signatura <br /> Cate (Revised2/2071) II� <br />