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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32b0 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �- �� �� <br /> S�10505 19th Ave SE, STE v pROVERTYT,��052000203200 PERMITp <br /> D U <br /> LEGAL�or newconsWctian: ShoA PlaVsubdivision � Lot No._ (attach copy ol lcnp legal desaiption) <br /> OWNER R A JOHNSON FAMILY LP P�onelE-mail <br /> oress 10511 19TH AVE SE STE C CiryfState2ip EVERETT, WA 98208 <br /> coNrnncTOR Shoreline Si n & Awnin �a i���.a SHORESA981JW <br /> aare55 �2101 Huckleberry Ln, Arlington WA 98223 pnonrhma�i ZOfr498-5327•kylene@shorelinesign.com <br /> TENA BUSINESS NAlME CON7ACT FOR PERMIT Kylene Knapp <br /> State Farm Insurance 206498•5327-kylene@shorelinesign.com <br /> PhonrlE•mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $3,500.00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Eiectnc Other_ <br /> Building rype: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ot projed: _New _Addition _Remodel _Repair_T.I.�Sign_Sprinkler_Demolition_Change ol Use <br /> Descnption Of WoAc(addifional space provideC on Ihe eeckJ: <br /> Have you slaRed working wiMiout a partnit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol P�oJttl: _Naw_Addn _Alleralion_Repalr Type of Project: _New_AOdn _Alteretlon_Repalr <br /> S6owNumDer/N)o/lLriures ShowNumber(p olfirtures <br /> AIC-air handlin unils Toilet <br /> Forced air s slems Bathtub <br /> Gas i in Lavato wash basin <br /> Waler heater � Shower <br /> Gas fire lace Kilchen sink 8 dis sal <br /> Gas ran e DisAwasher <br /> Clothes d er Clothes washer <br /> Ran ehood Waterheater <br /> Exhaust(an Sink servicelbarlmo letc. <br /> Meat um Badcflow revenler <br /> Unil heater Urinal <br /> Boile� Dnnkin Fountain <br /> Refri eralion Floordrain <br /> Woodstove Grease Va <br /> Dudin Roof drains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby cer'dfy lhat I have read and ezamined Ihis application an0 knaw the same to be nie anE atted.All provisions of laws and adinances goveming <br /> this rype of work will be complieC wiN whel7ier spetlfied herein or not.The granling af a permit dces not presume to 8��e aNhoriry to vioWte or WnGnl <br /> �he Owvlsion of any other state or locat law repulaunp oonslruction p tl�e peAortnance of oonsVuction.That I am auUmzed by the ovmer of Ihis properry <br /> t0 perfOrm 1 rk kr wTl apd���on is matle anG I[omD�Y�N e SL�te CAnVad Law 1827 RCW an0 296200 WAC <br /> uth rizad Agent Signelure ate (Revised?/tof f) <br /> \� <br />