Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERfDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.org 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 � y - � <br /> SITE ADDRESS: '� �� ���- � . PROPERTY TAX p �ERMIT k <br /> — � / i �I.��i�. �"�i ! __jl. i � � �� � � �L'� <br /> LEGALfornewwnSWclion: ShotlPlaVsubdivision__ ___._.________ LotNo.____.. lattachwpyollonglegaltlescnption) <br /> �,1, ., ,i'� ' f�� Phone/E-mail � 7; .., ��'� '.7��f/.; <br /> ly <br /> OWNER ', � �'.; i J �� .N %r L�� �/ <br /> J.,�� - Cit 15tate2� � 4�f l� / �-- / : i,'j� <br /> � J� 1 � <br /> Adtlress � L-� ��� � �' 7'"� y P <br /> � lJ' � .l , CY' � / <br /> CONTRACTOR ��7( ' � \.'L �l'l ��) C , L 81 Lic.# /?":'i��_:, , . <br /> , { ��—_ <br /> � � � PhonelEmail•-/.%--�� ��-� �'Y�—���` <br /> Address� � (�C�., ..i:� . . ; ��. f..f <br /> TENANT BUSINE55 NAME �� CONTACT FOR PERMIT ;%,/,`�l � ��.�.�✓, <br /> -> > ji•_ ';� _ �_,- - <br /> � ��,! ! 1� . . A . Phone�E-mail� —? �. ' � . � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE Of WORK_riy_��_" --- <br /> Exisling Use of Bwlding_____ _ _ HEAT SOURCE: <br /> ----------------- <br /> Proposed Use of Building_________ Gas____ Eiectric____ OIAer____ <br /> 8uilding Iype: __Single Family _Duplex_Townhouse __MultrFamily ,���Commercial <br /> Type of pmjecl: __New __Addition _Remodel _Repair_T.L�Sign___Sprinkler__Demolition___Change ot Use <br /> Description of Work(adtldional space provided on the backJ: <br /> 1 � � <br /> I :i.�IZC-C'':/ ,� C..<,'',�i'� '' �i„:Y" <br /> Have you started working without a permit7 _ __YES ___ NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT QPPLICATION <br /> Typoo(ProJect: .New. _Addn _ANeratlon_. .Repalr TypeolProject: ___Nuw ___Addo __ Alleralion__.Repair <br /> � ShawNum6cr(MJoIlixtures ShowNumber A olfixfures <br /> ' NC-air handlin unds Toilet <br /> ' Forced air s stems 6athtub <br /> � � Gas pi in ' Lavalo wash basin <br /> � � Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> I Gasran e Dishwasher <br /> '� Clolhes d er ' Clothes washer <br /> � Ran e hood ' Waler healer <br /> �l ' Exhausl lan � Sink(servlcelbadmo /elc. <br /> � �ackflow prevenler <br /> � � Neat pump � � Unnal <br /> Unit heater <br /> � �oiler ' Dnnkin Fountain <br /> Rc(ri erahon floordrain <br /> Woodstove ' Grease ira <br /> DucLn '� Roof drains <br /> � Olher __________ � �1edical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM ' otner. <br /> NumberofHeads �� Olher. <br /> I hereby cetlity that I have read and examined this application and know Ihe same lo be Irue and cortecL All provisions of laws and orGmances goveming <br /> ihis type of wnrk will ba complied with whelher spBCHied herein or not.The g�aming of a permit does not DRsume to give authonry to violale or wncel <br /> Ihe provision ol any o1�1er-state or local law regulaling construclion or the peAormance of consWdion.That I am authonzed by the owner o1 this property <br /> tp or�ihe work"for which application is made and 1 compiy wilh the Stale Contractors Law 1827 RCW and 296100 WAC `i <br /> i � � � <br /> ; ���� 2� �G �i �� <br /> OwneilAidhodzed Agent Slgnature �atf (Revised 2/201f) <br />