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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPL MBINGISIGN/SPRIN LER/DEMOLITION <br /> r <br /> t <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa,org <br /> PROPERTY TAX tt PERMIT# <br /> SITE ADDRF��� � _ - <br /> LEGAL.for new construction: Short Plat/subdivisfon�C Lot No (attach copy of long legal description) <br /> OWNER Y�Q,' 1�- PhonelE-mail 2FJ r�1)?) 2 0� <br /> r> City/State/Zip �tf�1 d 2 �- a Q <br /> Address `2.0 - W _Nj kL%kW-\ i 0 <br /> APPLICANT:—Owner ^Ovmers Agent X Contractor —Contractors Agent �Tenant(mostprovlde a rener ofconsentfrom the u.1marto do eork in the space) <br /> CONTRACTOR IVLti PaC �Lr]IIrJ l/� +�'t LG)�y�G) )state uc.# ` , r;+�1 '+�f l e City Bus.L1c.# <br /> l <br /> Address ( _ Qj(Gk�' �!1 PhonelEmail h�'ZS �7 r Do _ <br /> TENANT BUSINESS NAME C NTACT FOR PERMIT <br /> P i <br /> PhonelE-mail � �[O ✓ 100 <br /> BUILDING PERMIT" APPLICATION CONTRACT PRICE OF WORK��L <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: ,Single Family _Duplex Townhouse Multi-Family Commercial <br /> Type of project. New Addition Remodel Repair T.I. Si n S rinkler Demolition Change of Use_ <br /> DESCRIPTION OF WORK(additional space provided on the book): } <br /> 5a <br /> MECHMI ICAL PERMIT APPLICATION PLUMBING PEkMIT APPLICATION <br /> Type of Project; _Neer^Addn Alteration_Repair Type of Protect: _Now___-Addn —Alteration_Repair <br /> Shove Number(#)of fixtures Show Number(# of fixtures <br /> AIC—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Lavatory wash basin <br /> Gas piping <br /> Water heater Shover <br /> Gas fire lace Kitchen sink&des osal <br /> Dishwasher <br /> Gas range <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servicelbarlmo /etc. <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinktng Fountain <br /> Refrigeration Floor drain <br /> Woodstova Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other, <br /> I hereby ce"that I have read and examined this application and know the same to be We and Correct.AC provisions of laws and ordinances governing ois type of work vrdi be comp) <br /> wdth whether spe6fled herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local taw regulating construction <br /> r1-h m authorize by the ow of this properly to perform the work for which oppHoadon Is made and I complyvath the State Conlradors Law 5827 RCW and 296200A WAC. <br /> 1 Ui <br /> Owner/ uthorize Agent Sl ure Date {Revlscd9/20f4) <br /> I <br />