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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGlSIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl,WA 98201 - 425-257-8810—F�X 425-257-8657—www.evprett�va.org / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM II " b`� <br /> SITE ADDRESS: �k 5'� PROPEHTY 7A%p ERMIT � / _ n <br /> � f/ <br /> Z o0 v E 1r� - <br /> LEGAL for new con,tmcticn: Short FiaUsubdrvision L' LoI No._ ;3'.tac^.copy ol Icng legal tlescription) <br /> OWNER ,r7 L� (. �fl � JUf L;� u� phonelE-mad �7� /pJ-�77 U7• loYJe %f �� <br /> Address g ' � CitylStale/Zip '`TL� 8 0� <br /> CONTRACTOR "(B L 81 Lic.# <br /> Ftldress PhonelEmail <br /> TErN.P�.N,�T B�rUSINESS NAM� CONTACT FOR PERMIT qRL TdGL y <br /> 'S�'f� Cu'�De�s phone/E-mai12o6•62!•2251 /(JL�y(�u/�(iLy•�0� / <br /> BUILDING PERMIT APPLICATION CONiRACT PRICE oF WO'tK�?� ��v ; <br /> Existin3 Use of Building M�DI�A1- OfAC� HEAT SOURCE: <br /> Proposed Use o(Buildin Gas_ Eieadc h Other_ <br /> 9---- <br /> Building lype: _Single Family _Duplez_Townhouse ,_Mulli•Family ,�Commercial <br /> 'i ype of project: _New _Addition _,Remodel _Repair�T.I._Sign_Sprinkler_Demolitiuri_Change of Use <br /> DCSCriplion of Work�addilionel space pmvided on the back):EX/Sr�ti MLy����r CL/N/G T Ua�1�, <br /> 38[b .5� T/. tze,ua�����N of 5 <br /> �.yt� Cv.viG. <br /> Have you started working without a permit7 _YES �10 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype of Project: _New_Addn _Alleration_Repalr Typa a(Project: _New_Addn _Alteration_Repair <br /> Show Number(p)o/lxtures SM1uw Number I#1 o/lisfures <br /> A/C-airhandlingunits � ioilet <br /> � Forced air syslems BalhWb <br /> � Gas pipin I Lavato (wash basin) <br /> Water heater I Shower <br /> � Gas freplace � Kitchen sink 3 disposa! <br /> Gas ran e I Dishwasher <br /> Clothes dryer Clothes washer <br /> � Ran9e hood I Water healer <br /> � Exhaust fan � Sink(servicelbarfmopletcJ <br /> � Heat pump � Backflow prevenler <br /> � Uni�h=aler � Urinal <br /> Boiler � Orinkin Fountain <br /> � Refrigcration � Floor drain <br /> I Woods�ove � Grease irap <br /> � Ductin.� I Rooidrains <br /> � Olher__ � Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM I Gther. <br /> � Number o(Heads I Other. <br /> I hereby certify ihal I have reatl ana examine0 Iha application and know lhe same to be vue and ccrtect All provisions of IaNS antl orainances goveming <br /> ihis type of work vnll�e complied wilh whether specihetl�erem cr noL The�ranting of a permit tloes not presume�o grve aulhorily to violate or cancel <br /> Ihe p�ovision ol any other slale ar local law regulating cons�mction or the pedormance ol conslmction.Tnat I am authonzed by the owner ol this propeny <br /> lo oedo he v.ork� whicl plicatio i made and I comply vnU the State ConL•aclors Law 1827 RC'!J and 290".200 WAC <br /> /! , <br /> Ownc�lAuthoriied Agent Siqnat <br /> Date (Revised 2/207 f) <br /> l�a <br />