Laserfiche WebLink
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 /> SITE ADDRESS: /I / PROPERTY TAX# PERMITit <br /> Dom, �^ C i✓ "e__ Al l 0 V <br /> LEGAL for new construction: /Short Plat/subdivision _Lot No. (attach copy of long legal description) <br /> OWNER Of.� ! j t Phone/E-mail <br /> Address � _ 1" City/State/Zip <br /> APPLICANT: Owner _Owner's Agent —Contractor _Contractor's Agent _Tenant(must provide a letter otconsent from the owner to do work in the space) <br /> i <br /> CONTRACTOR C 15,,,15- CuA ��-� C L&I Lic.# P � SG- 9ACOE Bus.Lic.# <br /> Address i 1 t/e✓ G'� � �� Phone/Emailt ) 6 <br /> TENANT BUSINESS NAME 1 CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 ZQ, <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Caste Electric Other <br /> Building type: Single Family V Duplex_Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn Iteration Repair Type of Project: New Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 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 p 'it 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 th owner of this.operty to rform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> owner/Authorized ••e Signature Oide (Revised 6/2012) <br />