Laserfiche WebLink
���nni�r ������,��ri� <br />�ui��i����n�c�a�r�ic�L���.un�BiN��si��v�s��srv��.�����nno��-rwo�u <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />� � <br />/1UURCJJ. / / / /� / f � � <br />c�' �C <br />�L for new construction: Short PlaUsubdivision <br />ER / 1' 1 � �''L-�'�1/ �� � �� Z/ <br />� <br />;5 j � 3 c� � � .�✓,, �`I � �,� <br />ICANT: _ Owner _ Owner's Agent � Contractor <br />OR ; / <br />�7S- C L <br />e <br />/ � , <br />�� � .�ec'r�.�`:. �-P G-�< G <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # <br />2 �''� i� �✓� �, U C� <br />r# <br />No. (attach copy of Ibng legal description) <br />«� Phone/E-mail <br />Age�f _ T2f18f1f (must provida a leqer of conseN from the owner to dp work In ihe space) <br />itate L'Ic, # <br />J� � <br />��`� ,r, Phone/Email � L <br />,� <br />;ONTACT FQR PERMIT� <br />'�y" <br />'hone/E-mail � Z.r ,'� �% � <br />:ONTRACT PRICE OF WORK _ <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: ,_ Single Family _ Duplex _Townhouse _ Multi-Family ,�c' Commercial <br />Type of project: New _ Addition _ Remodei _ Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back): <br />�IjC.L?tic. �,G �.(� fl� � i/ l�-1 � ��" ,/,�' f � �'�P ��1� 1 <br />P <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas rar <br />Clothes <br />Range I <br />n <br />r <br />� �tner <br />SPRIWKLER / SUPPRESSIOId SYSTEM <br />Number of Heads <br />Y �f CC�, L.ic. # <br />s � � � �' �.�D �� � <br />�1�� �� <br />�`�'� � <br />r-�'��0,. [� C'i <br />HEAT SOURCE: <br />Electric Other <br />Chanqe of Use <br />1 <br />pe of Project: _New _Addn GAlteration _Repair <br />Show Number (#) of fixtures <br />ower <br />chen s <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo <br />Backflow preventer ( <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Medical Gas <br />Other: <br />Other: <br />al <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 />wi�h whether specified herein or n} �t. The granting 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 autho zed by the owsti¢1;6f this property 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 />� ,ii <br />l � � <br />/ `'� "�� � ,. ��' ..____._, � . <br />/-� r1 ,%" �1"'._ <br />� Owner uthorizedPfgent tt�iure ` at (Revised 4/2015) <br />