Laserfiche WebLink
• <br />PERMIT <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 />4DDRESS: PROPERTY TAX # T # <br />3,��1 ►3 Ll�r� iutcc� �t— `��i�' i20 I—(� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />A . 1 .� � <br />OWNER rfic <br />Address � <br />CONTRACTOR <br />Address <br />�el� o4;ne� <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail y L� - �� -Lj <br />City/State/Zip ky � � � � <br />L & I Lic. # —'"� <br />Phone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />- I�o`� <br />Existing Use of Building �'� - HEAT SOURCE: ��pC <br />Proposed Use of Building Gas Electric �' Other <br />Building type: Single Family �Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projec :_ New _ Addition _ Remodel � Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additiona/ space provided on the back) : <br />Have you started working without a permit? _YES _NO <br />MECHANICAL 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 />I Gas ranae <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <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 />� Toilet <br />Bathtub <br />( Lavatory (wash basin) <br />� Shower <br />Kitchen sink & disbosal <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: �--Y7 <br />Other: <br />� �� <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 <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel � <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to pe m the wo f ch a lication is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC �� <br />Ow e thon ed Agent Signatu Date (Revised 2/2011) <br />