Laserfiche WebLink
�J <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 />- �ti�� PU�;�,� ��� <br />A <br />for new construction: Short PlaUsubdivis <br />jdress J .�T � � <br />r <br />PPLICANT: _ Owner _ <br />ONTRACTOR l/ir�U <br />idress ."�j�/ j�j p�; � <br />�v; <br />Owner's Agent � Contractor <br />.��i 2 /.� "� Cc.� �,c�5 � . <br />Chc Id�'e�s �,1fi 5 � Cey�� �.s� <br />BUILDING PERMIT APPLICAYION <br />IPROPERTY TAX ti I�� "� 1 Dl/ J <br />Lot No. (attach copy of long legal description) <br />-,��1- � J`3�:> <br />� Phone/E-mail ti�5 � C� <br />City/State/Zip LNf�'7Z�f� i,Et�} : �l -',,: G�' <br />COf1if8CfOf�S /a98f1� _ T0fl8flt (must provide a letter of consent from the owner lo do work in lhe space) <br />State Lic. #� i�} y+�U ��i�6���� City Bus. Lic. # <br />k�,1 �.PJ/� �j� Z z.� Phone/Email ,��� - ?3 �l - 3L-ou <br />CONTACT FOR PERMIT <br />Phone/E-mail I�C � � W`�v/t�� }� i/L'`jvA/ �L�o b dJ�d •� t <br />CONTRACT PRICE OF WORK j� �� <br />Existing Use of Building �P,�Dt �Gi ( HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other � <br />Building type: _ Single Family _ Duplex _To�.vnhouse _ A�lulti-Family �( Commercial <br />Type of project: New Addition LC Remodel Repair _ T.I. Sign _Sprinkler _Demoli <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />���;►-�„�,- or 3 T����..� J w,+5 ��-s,�.urs /�- i���/c-�s <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn �(,Alteration _Repair <br />Show Number (#J 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 dryer <br />Range hood <br />� Exhaust fan <br />� Heat pump <br />i Unit heater <br />I Boiler <br />Woodstove <br />Ducting <br />,� � Other ;1,��/ j�n� II�'7+T Cu��, <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Chanqe of Use <br />PLUIVrBING �ERMIT APPLICATION <br />Type of Project: _New _Addn lC Alteration _Repair <br />Show Number (#) of fixtures <br />�- � Toilet <br />� Bathtub <br />�+c �. � Lavatory (wash basin) <br />j Shower <br />j Kitchen sink & disposal <br />j Dishwasher <br />; Clothes washer <br />� Water heater <br />� <br />� Sink (service/bar/mop/etc.) <br />I Backflow preventer <br />Urinal <br />Drinking Fountain <br />j Floor drain <br />Grease trap <br />; Roof drains <br />� Medical Gas <br />� Other: <br />i 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 (or which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. t <br />I � / <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />