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2.-0 l � o �-l"7 <br />PERMIT APPLICATIO� <br />BUILDING�/ MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES � j� �/1 � <br />3200 CEDAR STREET, EVERETT, WA 98201 �,C�,N; � � I L1, <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � wvwv.everettwa.�jov/permits <br />CONTACT INFORMATION <br />OWNER NAME: � v-L� }-�,�� �• G� TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srREET � � ( �Z�` � �,� -� �j� I <br />CITY ����'r STATE ' � �f^ ZIP �.�(j-� <br />OWNER PHONE: �"Z G� G��� � OWNER EMAIL: <br />CONTR,4CTOR NAME: MM COMFORT SYSTEMS <br />cONTR,aCTOR,a�DREss: sTREET18103 NE 68TH ST SE, G200 <br />CITI' �jl�MOND STATE WA ZIP 7HOS2 <br />CONTRACTOR PHONE: 425-881-7920 cONTRACTOR EMA��: JWELLS@ MMCOMFORTSYSTEMS.COM <br />CONTRACTOR LICENSE #(REQUIRED): MMCOMCS85564 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): OS424O <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 425-881-7920 <br />JANETTE WELLS CONTACTEMAIL:JWELLS@MMCOMFORTSYSTEMS.COM <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Contract Price of Work: $ .� <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: (�.� ,, <br />��L�� � ` ' �� C= �l,l�r�1�-'�- <br />l� `� �,.,�T��� �.�" �u..rn-� <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /># of List of Fixtures # of List of Fixtures #°f Lisi of Fixiures # of List of Fixtures <br />Fixtures Fixtures Fixtures Fixtures <br />� A/C — Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bldg) <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 Range Ducting Dishwasher Roof Drains <br />Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br />Range Hood Water Heater Other: <br />Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: <br />SPRINKLER / SUPPRESSION SYSTEM <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 />cur�ent 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 1 am authorized by the owner of this property to pertorm the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />OwnerlA�horiz�d Agent Signature Date <br />City of Everett O(ficial Use Only <br />PER �IT� # <br />2 �L� I � l�l ����J" L%�(y <br />(Revised 10/12/2015) <br />'1 � Q�c <br />� �, -/ <br />