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,everettwa.org <br />SITE ADDRESS: � � / <br />� —PROPERTY <br />TAX # <br />�� <br />' <br />PE MIT <br />G- � 0,9 <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />OWNER G J <br />Phone/E-mail JZ GLJ %2 <br />Address <br />City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent —Contractor _Contractor's <br />Agent _Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />tate Lic. # r'�Gv�/ �Q City Bus. Lic.. # <br />Address <br />Phone/Email <br />�' ��' <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail .%ZA0,, <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK : ,tQ G QQ <br />Existing Use of Building L- P:.- (:-7— <br />HEAT SOURCE: <br />Proposed Use of Building <br />Gas_ Electric_ other <br />Building type: _V!�ingle Family _ Duplex _Townhouse <br />_ Multi <br />-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ <br />T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />C"7o2 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />I A/C — air handling units <br />2 i Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />j Shower <br />Z Gas fireplace <br />( Kitchen sink & disposal <br />I Gas range <br />Dishwasher <br />j Clothes dryer <br />] i Clothes washer <br />Range hood <br />ater <br />j Exhaust fan <br />i Sink (service/bar/mop/etc.) <br />Heat pump <br />I Backflow preventer <br />Unit heater <br />I Urinal <br />Boiler <br />j Drinking Fountain <br />j Refrigeration <br />j Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />j Roof drains <br />j Other <br />I Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of HeadsIF <br />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 togive 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 prope o perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />_1 <br />Owner/ thorized gent Signature Date (Revised 312013) <br />