Laserfiche WebLink
�ERMIT APPLICATIO� <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: PROPERTY TAx # PERMJT # <br />l���c; �. _�-'� [7�'-�J�, ���-� i . i.►Ib �Y,``4(��7�%c'E�C-4�� i G ( , � _ � ` . <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER J�V,—r�`��i`'( �i[av��lT��" <br />1 <br />Address �� if} �� N• ���- YE'tV�•, �o�f''I�C + l, lLrt <br />No <br />PhonelE-mail <br />(attach copy of long legal descri��-�'ii't-� <br />4�� ,�y.'f —��y b x� -��, .- t c� i� � <br />���.� TT, �i !� � s� ��'� <br />APPLICANT: _ Owner _ Owner's Agent Contractor _ Contractor�S A98flt _ T@Il2flt (must provide a letter of consenl from the owner to do work in the space) <br />CONTRACTOR � il �,� �j L_ ►�.j� C; ��'"; L& I Lic. # �'' � 2 S �� �� � COE Bus. Lic. # <br />Address 7 % O / �-�% f_� /(�/�' i ! f�t,�C= �� (1 �_ �—i� L'�9/ i �Zo hone/Email I Z � — � � � `l ` � U J � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I�, L� � <br />Existing Use of Building C,�'� '3� <br />Proposed Use of Building �!� � Gas <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New � Addition Qc Remodel Repair _ T.I. _ Sign _Sprinkler _De <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />HEAT SOURCE: <br />Electric Other <br />olition Chanqe of Use <br />� ct'ri�i�-�� (�-1 i �cf�K� � �'�Iv f � i.._��.. � _ � kx5 t C.c"; ���.-� � �'� .�+71�� <br />A�an r��.��s ����r�� � P.�7� � , <br />MECHANICAL PERMIT APPLICATION <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 fireplace <br />� Gas range <br />j � Clothes dryer <br />� Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />I Boiler <br />Refrigeration <br />Woodstove <br />� 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 />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <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 lhat I have read and examined this application and know the same to be true and correcl. All provisions of laws and ordinances governing lhis type of work will be complied <br />with whether specified herein or not. 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 -orize y the owner of this property to perform the work for which application is made and I comply with lhe State Contractors Law 18.27 RCW and 296.200A WAC. <br />� � %s <br />� - ��--� <br />Own r/Authorized Agent Signature Date (Revised 6/2012) <br />