Laserfiche WebLink
, • <br />PERMIT <br />• <br />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 />ADDRESS: PROPERTY TAX it P RMIT # <br />►2oZ SHuKS�N wA� h�,z��,�� ���,i�a —nn- <br />EGAL for new construction: Short Plat/subdivision <br />OWNER <br />APPLICANT: _ Owner _ Owner's Agent XContractor <br />CONTRACTOR ��s�-. � h'� d-1- �` �t�G �� �,-�� <br />ress 2 � o -1 -7 pre <br />JANT BUSINESS NAME <br />�-�NKo <br />BUILDING PERMIT APPLICATION <br />GOMA <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip <br />_ COfl�t'BCIOf S A9@�l _ TBflBflt (musl provide a letter of consent from the owner to do work in the space) <br />o ti L& I Lic. #�PAT� ��'r�1-�UG1Gi G. � COE Bus. LiC. # OZy � q y <br />PhonelEmail Z$3.�71.�-L7-L, �,,�,�} <br />R PERMIT 5H�4 ,N� �y o!�-��,4�j <br />Phone/E-mail Z�� . Z$� •"3 �( OS Sha;n.�.Mo�9a� +�}�ie{4:�•� <br />CONTRACT PRICE OF WORK �/ Z� �I/ Z <br />� <br />Existing Use of Building HEAT 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 provided on the back) : <br />AtJO�RELOG•4T6 Sl��in�/LL�/<<i FOl� 7'. /. �.J.iLS 1 G£�L�n/G) <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn kAlteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Forced air systems <br />� Gas piping <br />' Water heater <br />E <br />E Gas fireplace <br />? Gas range <br />Clothes dryer <br />f Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater - <br />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 Fxtures <br />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/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 authority to violate or cancel the provision of any other state or local law regulating construction <br />That I a authorized y the owner of 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 />1�� <br />�� i 2 Zy � 3 <br />Own r/Authorized Agent Signature Date (Revised 6/2012) <br />