Laserfiche WebLink
� <br />� <br />PERMIT APPLICATION <br />B�ilLDING/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 />! y`d .S� /i'JAD/1a�v�I ,�Q �/�' wA <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER <br />jdress%t��jrS�jQ/j/l,o,trlQ /QIjG� L <br />PPLICANT: vOwner _ Owner's Agent _ Contractor <br />ONTRACTOR � L�I Yi � <br />ress <br />BUSINESS <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # <br />PERMIT # <br />No. (attach copy of long legal description) <br />hone/E-mail �f V.S' " Sg',� � %�S4 <br />ICity/State/Zip G v�jl�7"%� �� "��pZo3 <br />Contractor�5 A98�t _ T2f18f1i (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # <br />IPhone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Bus. Lic. # <br />Existing Use of Building ,/Lct,vG= HEAT SOURCE: <br />Proposed Use of Building .�'NS�iOLt ��t,Ci ��-T �Gl.� 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) :�it.STALt .Q ,sk7 /�oT lyl,i <br />� ..c. �4 �'x>a ��•��tiT S�A/.� 5 � ,ci ,c�d.ti ,�a�.�.c�' L,.c:�= <br />l�d�-T Ts//.f 1J �3 �� /.%G'i'�/4 �%9t iQ� ��p�s�2av1�'� L ac,/11ti� To� . <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� A/C — air handling units <br />j Forced air systems <br />j Gas piping <br />j Water heater <br />Gas fireplace <br />i Gas range <br />; Clothes dryer <br />Range hood <br />i Exhaust fan <br />Heat pump <br />1 Unit heater <br />� Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />! Bathtub <br />I Lavatorv (wash basin) <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined t' 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 not. The gr ng of a permit does nol 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 wner of thi roperty lo perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� / z �T�r.�J3 <br />�1� <br />ized Agent Signature Date (Revised 3/2013) <br />