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PER9VIIT APPLICATION� <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPR�N�CLERIDEMOLITION <br /> CITY C'F EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereti, W� 98201 -425-257-88'10— FAX 425-257-8857 —www.everettwa.org <br /> API'LICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEAODRESS � - PROPERTYTAXtt P ��'T IO� -c-I <br /> � 7��% �� -� � <br /> LEGAL lor new conslruclion: Shod PlaVsuhCivision_ Lot No._ (atlach copy of long legal descriplion) <br /> OWNER �j"1%l/� ��� � �-� PhonelE-mail <br /> Address City/SlalelZip <br /> CONTRACTOR ��") �/r����� � -Z7:' L& I Lic.# <br /> Address ,/r�$-/( � PhenNEmail <br /> TENANT BUSIN SS NAME CQ�J��F,qR PERN�IT v p,.-,. n�q� �G 7� <br /> � � /-lACVKC`7C �7� �r�r� -� i / <br /> � �,p ,L_ PhonelE-mail 1 4�� <br /> BUILDIN� PERMIT APPLICATION CONTRACT PRICE OF WORK � �� <br /> Exisling Use of Building _ HEAT SOURCE: <br /> Proposed Use ot Building_ Gas_ Elcaric_ Oiher_ <br /> Building type: Single Famlly _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of projecl: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DesCrip�ion of NlOfk(addifional space provideJ on the back):/�, 'I <br /> � YCo y �� �G�. <br /> Have you slarted working without a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypnofProJecL _New_P.ddn _Aiteretion._Repair 7ypoofProJecl: _Now_Addn _A'ceratlon_Repair <br /> Show Num6er(#)o//ixfurns Sh�,:v Numbcr(tt)ol(ixfures <br /> � FVC-air handling unas I Toilet <br /> � Forced air systerns _ I Baihlub <br /> � Gas piping ! Lavatory(wash basin) <br /> � Water heater I Shower <br />; j Gas fireplace I Kitchen sink 8 disposal <br />( � Gas range Dishwashef <br /> � Ciolhas dryer � Clolhes washer <br /> i <br /> � Range hood I Water healer <br /> � Exhaust fan I Sink(service/badmop etc. <br /> � Heat pump i Backflow prevenler <br /> � Unit heater I Urinal <br /> Boiler � Drinking Fountain <br /> Re(rigeration Floor drain <br /> Woodstove � Grease trap <br /> Ducting P.00f drains <br /> I Olher I Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> Number of Head; I Olher: I <br /> I Y�ereby wdify that I nave read and examined Ihis applica�ion and knew lhe same to be Irue and carect.All pmvisions ol laws and ordinances governing <br /> ihis type of vmrk eiill be complied with whether specifed herein or noL The grenting of a permit does noi presume to give aulhority to violate or cancel <br /> Ihe provision of any olher state or local laei regulaling consUuction or the peAormance ol conslmction.Thal I am autiiorized 6y the owne�of this propetly <br /> to perlorm ihe vro�fory�liich applicalio is made and I comply c�ith the Sta�e Coniractors Law 1827 RCW and 296.200 WAC <br /> � � �7-�/ <br /> � �,,� / =� i .� <br /> �OvmerlAutli rized Agent SI �natur Date (Re!4s�d 2/2071J <br /> -_ —_ - __----_ " ��� <br />