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20// 4212-
<br /> PERMIT APPLICATION
<br /> "' BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION
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<br /> CITY OF EVERETT PERMIT SERVICES tV-1
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<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits
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<br /> PROJECT SITE ADDRESS:2209 23RD ST PROPERTY TAX#:
<br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
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<br /> OWNER NAME:DEWAYNE JOHNSON TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTREET2209 23RD ST
<br /> cm( EVERETT STATE WA ZIP 98201
<br /> OWNER PHONE:425 879-1304 OWNER EMAIL:
<br /> CONTRACTOR NAME: MM COMFORT SYSTEMS
<br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200
<br /> crry REDMOND STATE WA ZIP 98052
<br /> CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL:JWELLS@MMCOMFORTSYSTEMS.COM
<br /> CONTRACTOR LICENSE#(REQUIRED):MMCOMCS85564CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) `I , 'E�I
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<br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT
<br /> 81-7920
<br /> CONTACT NAME:J E NAH BARLOW CONTACT EMAIL:JWE L S@MMCOMFORTSYSTEMS.COM
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<br /> Existing Use of Building: Contract Price of Work:$ �/QV
<br /> Proposed Use of Building: Heat Source: ❑Gas 'Electric ❑Other
<br /> Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial
<br /> Type of Project: ONew TANddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use
<br /> DESCRIPTION OF WORK:
<br /> 2 HEAD DUCTLESS HP INSTALL
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
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<br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair
<br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures
<br /> Fixtures Fixtures Fixtures Fixtures
<br /> NC—Air Handling Units i'Heat Pump —Toilet —Backflow Preventer(Inside Bid.)
<br /> Forced Air Systems Unit Heater —Bathtub —Urinal
<br /> Gas Piping —Boiler —Lavatory(Wash Basin) —Drinking Fountain
<br /> Water Heater Refrigeration —Shower —Floor Drain
<br /> Gas Fireplace Wood Stove _Kitchen Sink&Disposal _Grease Trap
<br /> Gas Ran.e —Ducting —Dishwasher —Roof Drains
<br /> Clothes D er Hookups —Other: —Clothes Washer —Medical Gas
<br /> Range Hood —_— —Water Heater —Other:
<br /> Exhaust Fan —Sink(Service/Bar/Mop/etc.)—Other:
<br /> .5_ ,,gy p_l. I ratl1 s �_ _A=4: 7
<br /> Number of Heads
<br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with
<br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the
<br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made,
<br /> and I comply with the State ntractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Official Use Only
<br /> it/03//7 PERM, c...1 r1r . / �4 . .....�1
<br /> Owner/Autho ized Agent Sign u e Date (Revised 10/12/2015){ D(7v
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