Laserfiche WebLink
• • <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.everetfinra.org <br />ADDRESS: <br />d �� r 6= i,'� �'�e a`� ��fie'f ��' <br />PROPERTY TAX # <br />L`'�����ti�a�i'�1�;a6��' <br /># <br />LEGAL for new construction: Short Platlsubdivision Lot No. (attach copy of long iegal description) <br />ER G'°'�d.���� A�j`,�i�-�6"�� G�'Q���''��"�* Phone/E-maii���-�";���" .�°'���8�' <br />�S �A r� <br />3s _�"11 �� 0 � 'h-� li : ,- : {,� �i.= City/State2ip s�^' i�il s''���ii �i i�F" . <br />.�s:��� <br />,���.L� <br />�'� � �� �' �'= �7� <br />�LICANT: _ Owner _ Owner's Agent � Contractor _ Contractor'S Agerlt _ T2�8nt (must provide a letter of consent from the ovmer to do work in the <br />NTRACTOR �•`�'��,�-�(...� ��;,�'}'l��=�`"' �"�: Ud�-¢''� State Lic. # fl-�C�4{2�'� �� �G � � � � City Bus. Lic. #f"`�,�j{)�; <br />ress:��`�� �� :1�i � ;�``^�i`.� ;m`R= �°`a�v��-�" J+,i � i�� Phone/Email�l'�'f �k�-` -��� �"D <br />�ANT BUSINESS NAME CONTACT FOR PERMIT <br />�� � �� � ,� � � � � ;w.�. � a.� <br />: � _, g.�r.. <br />Phone/E-mail ,�� :1 � t y'�.; �3_C-��'!.� ��� �J4,. y t-�1�=; � � C �:; g'�`'j <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: �* Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New Addition Remodel _ Repair _ T.I. <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />p ��� eK i �� r�11t� � �^�� <br />MECHANICAL PERMIT APPLICATION <br />of Project: � New_Addn _Alteretion _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 />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />T PRICE OF WORK <br />HEAT SOURCE: <br />Gas _ Electnc Other <br />Commercial <br />�ign _Sprinkler �Demolition_Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: � New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Kitchen sink & di� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bad <br />Backflow preventi <br />Urinaf <br />Drinkinq Fountain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify lhat I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be comp <br />with whether specified herein or not. The granting of a pertnit does not presume to give authorily to violate or cancel the provision of any other state or local Iaw regulating construction <br />That I am au rized by t e owner of lhis property to perform the work for which application is made and I comply with the State Contractors Law 7827 RCW and 296200A WAC. <br />� <br />�^� � <br />wner uthorized Ag ig ture Date (Revised 4/2015) <br />