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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: -'. / ��� / / J7 PROPERTY TAX # 4�ERMIT #1 <br />�� � l / // "t l � / {� �'�r/t l�f� /� ��//.� �` s /I/'' _i1/?l//�� :.2/�� � l .t % � ,�X i ,�I -C%� <br />LEGAL for new construction: Short Plat/subdivisi <br />OWNER iJ�%�.� ��%./ � C� l�F'`. <br />ress ��'�j(/ <br />! <br />'LICANT: � Owner <br />% <br />ress <br />,� �'C i�/ <br />No. (attach copy of long legal description) <br />Phone/E-mail �"J� �� � � �— �J��/Gj <br />City/State/Zip <br />Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �mus� pro��ne a ieuer or consem r�on, m�; owner �o ao work �n �r,e space� <br />BUILDING PERMIT APPLICATION <br />L&ILic.# <br />IPhone/Email <br />NTACT FOR PERMIT <br />hone/E mail <br />ONTRACT PRICE OF WORK <br />COE Bus. Lic. # <br />Existing Use of Building �G�� I-�EAT 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 �p>rovided on the back) : / <br />�t C�/b G�/ % ,r�f.��` /C-'dl [-L/G%Ci�/� �:/Cm �/i i ✓� l %�� o�l� �/ "�Q ,/l��!�ci �/ `( ,� Ll %��--i <br />! � > <br />� �' � G'�,21"r` P -r" C � �/'�'r'' livC"r�'� �'�'/�'/ <br />�i`C"-�G, l��" fL'�1.C.�! li/l� � �16Z�1�/G=c n? . � � C1'- �� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration�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 />Refrigeration <br />Woodstove <br />' Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYS <br />Number of Heads <br />Type of Project: _New _Addn _Alteration �Repair <br />Show Number (#) of fixfures <br />� Toilet <br />Bathtub <br />f Lavatory (wash basin) <br />/ Shower <br />;� Kitchen sink & disposal <br />', l Dishwasher <br />Clothes washer <br />; Water heater <br />Sink (service/bar/mop/etc.) <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 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 aulhority to violate or cancel the provision of any other state or local law regulating consVuction <br />That I am authorized by the owner of this propeiiy to perform the work for which application is made and I comply with the State Contractors Law 1II 27 RCW and 296 200A WAC. <br />_ _ __ � �_ `1z <br />�s <br />OwnerlAuthorized Agent Signature Date (Revised 6/2012) <br />