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� <br />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 />EQQ,QBESS: , PROPERTY TAX # P�MIT # __ �- <br />GAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />V F3-rL e o�.•� �..�r ' s /�-SS o o, .}.�-, o v� <br />�NER c P�son's f�r M4v w�cn Phone/E-mail �i9L5.�M7•59�x, '�.��.�� �, <br />i�ess i S`331 �IE 8�'' 51- �,�.; �-� 2ou City/State/Zip (� u�,,� �� , q�UO� <br />PLICANT: _ Owner �Own2� S AgOnf _ COnf�8CY0f _ COnl�2ClOf S Ageftf _ T0n2�� (must provide a letter of consent from the owner to do work in the space) <br />I I �5 n! i`fa� Sfi. <br />BUILDING PERMIT APPLICATION <br />�� ILE�ILic.# <br />�J,� . <br />COE Bus. Lic. # <br />_ �Phone/Email 2�, 6�}5. %Qj37 <br />FOR PERMIT ^J�,,N �,/ �, ZCov.S� ��-An��s. <br />H25, 2y$. 1782 <br />NTRACT PRICE OF WORK ��1 Z�J �.�'(S <br />Existing Use of Building /YIUG%/ e��'�'J�Lj'' �c.,�'!�E'l1s1�i�'gZ HEAT SOURCE: <br />Proposed Use of Building %V� �E�"fi'� �,'oE Gas E <br />Building type: _ Single Family _ Duplex _Townhouse X Multi-Family _ Commercial <br />Type of project: New Addition Remodel i�Repair _ T.I. Sign _Sprinkler _Demolitior <br />DESCRIPTION OF WORK (additional space provided on the back): <br />l��/'.a � 2 v�v v 2 i�c. � � O I.�E�� � S PF i'i�t' <S" <br />t 4 3 r/ �v ir lY! �s G T �- P�'i r 4� �,e' s'a�'ac'r�J-,�,�C, ��",�'Gt'',� <br />MECHANICAL PERMIT APPLICATION <br />e of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handling units <br />� Forced air systems <br />� Gas piping <br />� Water heater <br />� Gas fireplace <br />� Gas range <br />I Clothes drver <br />� Exhaustfan <br />� Heat pump <br />� Unit heater <br />� Boiler <br />� Refrigeration <br />� Woodstove <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />e of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of finfures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />I Shower <br />Kitchen sink & di� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow prevent� <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified 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 law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />� . / � 2 �2� I 3 <br />Owner Authorize Agent Sig�ature Date (Revised 6/2012) <br />i <br />Z_ <br />