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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBI NG/SIGN/SPRINKLER/DEMOLMON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA E18201 -425.257-8810—FAX 425-257-8857—Www,ev`erreltwaa.rg I Z <br /> APPLIC 11TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERTY TAX N PERMIT j <br /> SITEt ADDRESS: t c, Z 0 0 w o 0 �I <br /> (a1teN copy of loop legal desuipIon) <br /> LEGAL for new construction: Short Playsubdlvlslun _ <br /> OWNER ( Lot No._ <br /> r�r � 'n Phone/E-mail <br /> Address I I)t , VJ A. CitylState/Zip <br /> CONTRACTOR <br /> - -li4t,.,,,ti, L&ILIc.9 <br /> I�C, �'♦1/, PhonelEmad <br /> Address V 7 CONTACT FOR PERMIT`-�" s <br /> TENANT BUSINESS NAME 5ht= ilc-M Pn ol�� ^�) <br /> L5� 'I[� <br /> (\1 T v�e�, 1 PhcnelE-mail -4k <br /> BUILDING PERMIT AP LIGATION CONTRACT PRICE OF WOR JO > <br /> �L,1. �_v HEAT SOURCE: <br /> Existing Use of Building 1 <br /> C ^ N t [ Ctin S Ftl '. "'U"7Eectric Other <br /> Proposed Use of Building ' <br /> Buildi^gtype: _Single Family _Dupbx_Townhouse —Muhl-Family _Commercial <br /> _Demolition_Change of Use <br /> Type o1 project: _New _Addition —Remodel _,Repair�T.I._Sign_Sprinkler <br /> Description of Work(additional space provided on the back): Is�1 <br /> Have you started working without a Permit? /_YES I Ott ` <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New, _Addis KAllanllon_Repair Type of Project: _New_,Addn _Alteration__Repair <br /> Show Number N of erfures <br /> Show Number(N of erfures Toilet <br /> i ,r, A/C-atr handlln tori <br /> Bathtub <br /> Forced air Is stems Lavato wash basin <br /> GasI In Shower <br /> Water heater Kitchen sink&itis oral <br /> Gas Bre lace Dishwasher <br /> Gas rancle Clothes washer <br /> Clothes dryer Water heater <br /> Ran is hood Sink servlcelbarhra lett. <br /> Exhaust tan Backflow reventef <br /> Hea: um Urinal <br /> Unit heater - Drinkin Fountain <br /> Boller - Floor drain <br /> Refit station Grease ire <br /> DuctlnWoodova Rool drains <br /> Duclm <br /> Medical Gas <br /> Other_ <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Olhec <br /> I hereby certify that 1 have read and examined this application and know the Game In be true and correct All provisions of Isws and ordinances governing <br /> this type of work will be Complied with whether specified herein or not.The granting of a permit does not presume 10 give authority to violate or anal <br /> ruction <br /> lop prevision erform the oany other f <br /> to,which appl"llon a made and 1 amp tiOn Or the with this S�e Contnclors Lowt1B R Wa alam authorized by nd 296 200 WAC l�miner of this Properly <br /> 2 22 f2 <br /> Date (Revised 212011) <br /> OwnerlAbl odaad Agent 5i0nalurn <br />