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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-tl810—FAX 425-257-8857—www.everettw�a.org��`/� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ✓ <br /> P RMITR <br /> SITEADDRE55: /i� � PRQ��TAXp OD O v�j j (�C- Q��j <br /> u <br /> LEGAL for new conslruction: Short PlaUsubdivision _Lol No._ (attach copy ol iong leoal descnplion) <br /> OWNER � � 'UL P�onelE-mail <br /> ddress City/State/Zip A <br /> CONTRACTORI� IL �SF d� L&ILic.# M�NfCC �y� <br /> � � /�� �L L PhonelEmail ��7�3'��•� ��,�E���� X•CO� <br /> Address T � NY� 7 �5 <br /> CONTACT FOR PERMIT <br /> T/E�NANT BUSINESS NA�ME ��n.,r .I .�.1� QMI� t �1,,,��� J ' <br /> �TLT171Ll� ' 'N�' "• -L ��"r��l �Iv� P�one/Emall O�'��� ' � �fhc�I�KIG1�1 J✓ . � <br /> BU:LDING PERMIT APPLICATION CONTRACT PRICEOF WORK �.� � <br /> HFAT SOURCE: <br /> Existing Use of Building <br /> Ptoposed Use of Building Gas_ eiec�nc_ Other_ <br /> Building type: _Single Family _Duplex_Townhousa _Multi-Family _Commercial . <br /> Typeofproject: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition,_Change ofUse <br /> Desuiption of Work(addifional spaco provitled on the bach)� <br /> Have you started working without a permitT _YES _NO � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> • T e of Pro ect: _New_Addn _Alteration_Repair <br /> TypaofProJect; ,_New_Addn _Alteretion_Repalr yP j SM1owNumber(a)olflirfures <br /> ShowNumber(tgo/lixtures � Toilel <br /> A/C—airhandlingunits �� Balhlub <br /> � Forced air syslems <br /> Gas piping Lavalo wash basin) <br /> � Water heater � Snower <br /> j Gas freplace Kilchen sink&dis osal <br /> Gas ran e Oishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Waler heater <br /> Exhaust fan � Sink(servicelbar/mo /etc.) <br /> Heat pump I Backflow reventer <br /> Unit healer UAnal <br /> Boiler <br /> Drinkin Fountain <br /> � Refri eration Floordrain <br /> Woodstove Grease Uap <br /> I � Roof drains <br /> � Ducling <br /> � Other Medical Gas <br /> SPRINKLER/SUPPRESSION SXSTEM I O�her: <br /> Number of Heads i Other: <br /> I hereby certiF�that I havo raad and examined this applicalion and know the same to be tme and correct.All provisions nf laws and ordinances goveming <br /> this type of wo�k will be complied wilh whether specified herein or not.The granting of a permil does not presume to give aulhonry lo violate or cancel <br /> the pwvision ol any olAer stale or local law regulaling consWct!on or the pedormance of construction.That I am authorized by the axner ol this property <br /> to peAorm tho work!or which applicalion is made and I comp �il�the$tale Conlractors Law 18.27 RCW and 298200 WAC <br /> /l <br /> _ � , n,� �i S:�a- ra <br /> u�hori ed Agent Signature <br /> �ate (Revised 7/2of il <br /> ,I7/ <br />