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i <br />� <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 S AM TO 4 PM <br />;DDRESS: �2o T ���� � I�Q� PROPERTYTAX # PE�I�� ��6) � <br />1 t <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />V13'('L eOwYw� S /�-SSoc�•}�or <br />OWNER L�..IWi�PL.orSon�S nr„r��..-d-t. /�14.va�w.� Phone/E-mail �1%S.%�17•59W /���1.ntn��.t�i.v�2rr <br />�ess ( S`3 3 I NE 8�'' S% <br />'LICANT: _ Owner �Owner's Agent <br />NTRACTOR (MGLCvd C.c�n <br />ress ) � �5 /J I �D�` .S�' <br />� �-L ZOp ICity/State/Zip ��(�/� , �� . / �j (�(��j <br />COf1Y�8CY0f _ COnlf2CtOf S Ag2flf _ TEflBfll (musl provide a letter of wnsent from the owner to do work in the space) <br />`C �L&ILic.# <br />W�. <br />5I Dll COE Bus. Lic. # <br />645. �837 <br />.J�rn L/ c�J ZLo�s� I#�n�+-s. <br />Phone/E-mail �25, 2�}2J• �%t32 <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � LP, 2 3 �� 4g <br />Existing Use of Building �UliT/ ���Lj� �*',Y'!�E'lisJ`/�i= HEAT SOURCE: <br />Proposed Use of Building %�/Ga �t�"/9'� �o� Gas Electric O <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 />/� ��'.� I/�. l/'v v r�, e�.. F�` � D d� �� t� �' t�F- ,�'"�r" �.S'" <br />(� 3 �✓ �v �r �t�7 r� G � i- F��-r-�, � 4yo �e ���ca`�.J-i',� �s� j�cr},,�c <br />MECHANICAL PERMIT APPLICATION <br />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 />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />� 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 frxtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow prever <br />Urinal <br />Drinking Fountal <br />Floor drain <br />rcoot drains <br />Medical Gas <br />Other: <br />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 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 18.27 RCW and 296.200A WAC. <br />/ � 2 �2f� � 3 <br />Owner Authorize Agent Sig ature Date (Revised 6/201 Z) <br />�/� <br />