Laserfiche WebLink
*PERMIT APPLICATI <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: PROPERTY TAX# P RMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNE r 4 Phone/E-mail <br /> AddressRo 3� City/State/Zip `� D �v tip <br /> APPLICANT: Owner }Owner's Agent _Contractor _Contractor's Agent _Ten ant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMITjj /r/i* G/(I� /os�! <br /> 4(7 <br /> Phone/E-mail �G l� G. yZ 5 /Gr <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 5-co <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other <br /> Building type: _Single Family _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 _Alteration_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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I 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 9,rantin 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 authori y th ow er oft ' rop y to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Own /Autho ed t Signat Date (Revised 4/2015) <br /> 'Jy <br />