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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: ° �� PROPERTY TAX# PE IT <br /> 13 SE, c` - �� bOO r\Ooo 1C1 c.Do3 <br /> LEGAL for new construction:` tShort Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER RP '-4E V c st tl ,S Phone/E-mail <br /> Address k-4"S4* KT..OJP.0 [\J City/State/Zip PAW. w �Q`31 <br /> CONTRA�CTO�RI r�R- 1_,I_ <br /> (D , c-5 MaNei,tT.{d L&I Lic.# <br /> Address �(0 CC+k k1/41-%k1/41-% 5��� J R (169(u Phone/Email A1)•— �o�>,—( 3(o <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ��rr-�� <br /> Phone/E-mail bt� Com <br /> tht\- - 1,0%drA.(,Q, \t, t� . c%Ivy <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Om <br /> Existing Use of Building SF HEAT SOURCE: <br /> C <br /> Proposed Use of Building J4eQ$ L S. \ A)S tJ Gas_ Electric Other_ <br /> Building type: Y Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: New _Addition Remodel Repair T.I. SignSprinkler Demolition Change of Use <br /> Description of Work(additional space provided on the back): <br /> Have you started working without a permit? _YES 'x NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> \\ I Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws 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 to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perfo e work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> SP/ <br /> Ow r •u—fir . = - . . e Date (Revised 2/2011) <br />