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PERMIT APPLICATION <br /> BUILDINGIMECHANICAI._IPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 982o� -425-257-8810—FAX 425-257-8857—www•everettwa.org <br /> AppLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM P MIT tJ <br /> SITEADDRESS: �u 5'� ��3 PROPERN7A%N '� _�`G� <br /> V <br /> � ' � ' <br /> Lot No._ (atiach copy ol long Icgal description) <br /> LEGAL for new construction: Short Plallsubdivision — <br /> OWNER Gi2�e 13rG•��.dr1 PhonelE-mail .aC�•� ��'!-La � ����vV•��'' <br /> CirylS�alGZip �;� e ?S A . �7 F1�2A <br /> Address � .SA-cd L��t <br /> CONTRACTOR ch L&I Lic.# <br /> Phone/Email <br /> Address CONTACT FOR PERMIT �R-'° ���"`�"� �T �i3 <br /> TENANT BUSINESS NAME - u Z� �6a r <br /> PhonelE-maiILGA�t� �=-�`"�^� �a�'�d ' '�"h <br /> BUILDINGPERMITAPPLICATION coN7RACTPRICEOFwoRK <br /> HEAT SOURCE: <br /> Exis�i�g Use of Buiiding <br /> Gas Electric_ Olher_ <br /> Proposed Use p/f.Building <br /> Buildinglype: [�.SingleFamily _Dupi?z,_.Townhouse _.Multi-Family __Commercial . <br /> Typeofproject: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler,_Demolilion__Change ofUse <br /> Descriplion of Work(addifional spare provided on Ihe backJ: <br /> P � n 4^r.fv.t� '�> I '`=!` ;��� <br /> I�r _ ��.c � <br /> Have you started working without a permit? _YES _,NO <br /> MECHANICAL PERMIT APPLICATION <br /> p1.UMBING PERMIT APPLICATION <br /> TypoolProJect: _Now_Addn �,Allerallon_Repalr <br /> 7ypeolProjecl: _New_ACdn _.Allcratlon_Repair ShowNum6er(lgollOcfures <br /> Show Num6er(a)ol fi.dures Toilel <br /> � A/C—airhandlingunits � BalhWb <br /> � Forced air syslems � Lavalory(wash basin) _ <br /> � Gas piping � Shower <br /> � �Vater healer � Kitchen sink&disposal <br /> � Gas tireplace Dishwasher <br /> Gas range Clothes washer <br /> � Clothes dryer Water healer <br /> — Range huod � Sink(servicel'uadmopletc.) <br /> ; Exhaust fan � Backflow preventer <br /> Heal pump � Urinal <br /> Unit healer Drinking Fountain <br /> "� 6oiler floordrain <br /> � Refrigeralion � Grease trap <br /> � Woodsiove � Roof drains <br /> � Ducting Medical Gas <br /> � Olher _ <br /> SPRINKLER I SUPPRESSION SYSTEM � Other: � � <br /> I Olher. <br /> I Number of Heads <br /> I herehy certify that I havo read and examined Ihis application and know Ihe same lo be lrue and cc.recL Ail provisions ol laws and ortlinances go•:eming <br /> this type ol work�vill be complied alth whether speci�etl herein or nol.The g�anting ol a Fermit does net presume to give autharity to violate or wncel <br /> the provision ol any other slate or local law regulating consWction or the pedormance ol construction.Thal I am authorized by tha owner ol this property <br /> to peAorm tho�mrk lor�vhich ap�J� ' n is made antl I comply wilh tho State Cont�actore Law 78.27 RCW and 298200 WAC <br /> �-� �/s� <br /> �, � ' ( Z (Revised7/1011) <br /> OwneilAyd�ITZ 9eut . ate <br /> J <br /> /, ,/ <br /> C� <br />