Laserfiche WebLink
• <br />G <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 />fEADDRESS: �� / �f�}n � �� �� PROPERTYTAX# � i�� (� — U�/C <br />'`" c` �- <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />t %'� � �Y- � 1�- L{J �� �= � / e� hone/E-mail �. — L/ � �G �"�Z� � � <br />� � �'( � City/State2ip � \ j � /� L � 1 ,l 1 � 7 <br />. Ovmer <br />2 <br />Owner's Agent _ Contractor <br />, r�' ;4 —,� s�'l /,� <br />L� <br />/ /--r � N � / L. f`� � /� L G (.� �� <br />BUILDING PERMIT APPLICATION <br />Contractor's Agent _ <br />� L&ILic.# <br />U � <br />_ TeflBfli (must provide a letter of consent from the owner to do work in the space) <br />� k//c.� k�� � Bus. Lic. #GJ 5 ZO <br />Phone/Email L�,�S "' j..s3-----� 7.j <br />DR PERMIT __� <br />� � , l2f�% ,`� ( cm�� <br />�� �E.� �--.5 S 3 p�11 7.� <br />PRICE OF WORK ycF�v � w�' <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Si�gle Family _ Duplex Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel Repair T.I_ Sign Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />�, /l} .� �% !-t � �- ;� �i f � X 'J ' � L i� /ii1 /� Cij � � � � ��� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show IYumber (#) of frxtures <br />' A!C – air handling units <br />Forced air systems <br />Water heate <br />Gas fireplac <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaustfian <br />Unit heater <br />Boiler <br />Refigeration <br />Woodstove <br />Ducting <br />Other <br />► SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Kitchen sink 8 c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Backflow prevei <br />Urinal <br />Floor drein <br />Grease tra <br />Medical Gas <br />Other. <br />Other. <br />I hereby certify that I have read and euamined this app6calion and know ihe same b be Vue and correct All provisions of laws and ord'mances goveming this type of work will be complied <br />with whether speafied herein or not The gran6ng of a pertni[ does not presume to give aulhority to violate or cancel the provision of any other state or local law regulating consWclion <br />That I am authorized by the owner of this property to perform the woric for which applicaGon is made and I compty with the State Contractors Law'18.27 RCW and 296.200A WAC. <br />� - � C� � �. <br />- �- �'s�� -� l � �3 <br />Owne�h4uttiorized AgenYSign e " Date (Revised 6/2012) <br />