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PERIWIIT P��PLICATION <br /> BUILDING/MECHANICAL/PLUME31fvGISIGNISPRINKLER/DEMOLI'CION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-3810- FAX 425-257-8857-www.everettwa.on�� <br /> APPLICATIONS ARE ACCEPTED FfiOM 8 AM TO 4 PM �.-7 -�I( <br /> PNOPERN"fAX X PERMIT# <br /> c�,��nl -�;I1 <br /> �3c� I i 'c !-t A�Iz � D - <br /> LEGAL for new consUuction: Shotl PlaVsubdivision Lot No,_ (atlach copy of long legal description) <br /> owNeRSNoNorIZSN C-O f��13�-yL ���5 P��onelE-mail <br /> Address !DO /-/Ai DE.Son/ � CitylStatelZip EUCSZC�T �� � �Zv.3 <br /> CONTRACTOR r h'15C TT i"1C-.�N ��-Z�L L 8I Lic.# <br /> Address <br /> Z 6 3 `J� �/5 r Phone�Emaii <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATIdN CONTRACT PRICE OF WORK <br /> HEATSOURCE: <br /> Existing Use of Building <br /> Proposed Use of Building Gas_ Electnc_ Other_ <br /> Building type: Single Family _Duplex_i ownhouse _Multi-Family _Commzrcial <br /> Type of project: _New _Addition _Remo�Jcl _Repair_T.I._Sign_SprinYier_�emolition_Change of Use <br /> Description of Work(additional space provided on the ba�.k/: <br /> Have you started working without a permit? __YES ,_NO <br /> MECHANICAL PERMIT A�PPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Now_Addn _Alteration_Ropair Typo of Project: _Now_Addn _A��eration_Repalr <br /> Show Number(#)ol fixtares Show Number(#)of/ixtures <br /> � NC-air handlinr units _ I Toilet <br /> � Forced air systens _ I Bathtub <br /> Gas piping _ I Lavatory(wash basin) <br /> Wa' :heater _ I Shower <br /> � Gas fireplace _ � Kitchen sink&disposal <br /> Gas range ,_ I Dish�vasher <br /> Clothes dryer _ � Clothes washer <br /> Range hood _ I Water heater <br /> Exhaust fan _ Sink(service/barlmoplelcJ <br /> Heal pump _ � Backflow preventer <br /> � Uni�heater _ I Urinal <br /> Boiier _ � Drinking Fountain <br /> Re(rigeration _ � Floor drain <br /> Woodstove _ I Grease trap <br /> Ducting _ � Roof drains <br /> Olher _ � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ I Other <br /> Number ol Heads — -- <br /> I hereby certify Ihat I have read and ezamined Ihis application and know�he same to be true and cormct.All provisions of la•,vs and ordinances governing <br /> Ihi�type of work will 6e complied with whether specified herein or nol.The granting of a permit does not presume lo give aulhority lo viola�e or cancel <br /> the provision ol any other stale or local law regulating constmction or the peAormance ol construction.That I am aulhorized by the ovrner of this propetly <br /> to pedonn the vrork for which applicalion is made and I comply with Ihe Slaie Coniractors Law 1827 RCW and 29�200 WAC <br /> ` /��—/ �� ���� (Revised 77120�0) <br /> OwnerlAulhorized Agent S(g uro Oale <br />