Laserfiche WebLink
� i <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 />SITE ADDRESS: ° <br />(..� .,,�,.,� v,�'�lCf <br />LEGAL for new construction: ShoR PlaUsubdivision <br />.� ;' 1 f <br />OWNER � �C'il��!C��tll�t� � Ci '/!'(��/ <br />7 <br />Address ,f��� �C�X �> �%L�('� <br />APPLICANT: � Owner _ Owner's Agent _ Contractor <br />CONTRACTOR ,' � /�,.' �. , � .l� � ��.• �j-��; � �c< <br />dress <br />E <br />� <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # <br /># <br />�� <br />Lot No. (attach copy of long legal description) <br />Phone/E-maii S — � �/ •' ,'.��� � <br />,+ -� <br />City/State/Zip f "�'��/ / ^' ^��, �� ,J <br />COf1tf8CtOf�S ACj2flf _ T2118f1t (must provide a letter of consent from the owner to do work in the space) <br />�• C' �State Lic. # <br />hone/Email <br />Y <br />ione/E-mail (' ��,�� ; �- ( �� <br />ONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : ; <br />� , , ���-,i,�� ; �y („I�'ury�. <br />,,/�r; �GT(r i���c��^ C:�G:✓;! �' c�ii�i �,7Clc��ir ,; ' <br />i ` <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _,Alteretion _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />i Forced air systems <br />i Gas piping <br />i Water heater <br />Gas fireplace <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� Ducting <br />� Other <br />RINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Bus. Lic. # <br />��5�l�!�'� , <br />. �i' ,�_5- � � <br />HEAT SOURCE: <br />Electric Other <br />Demolition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />j Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & disposal <br />j Dishwasher <br />j Clothes washer <br />; Water heater <br />; Sink (service/bar/mop/etc.) <br />; Backflow preventer <br />Urinal <br />i Drinking Fountain <br />i Floor drain <br />Grease trap <br />Roof drains <br />i 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 am authorized by ihe owner of this properly to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�----- � ; <br />� _ i <br />L c'�"-. ' ___ _.._._._. !i ? <br />��• _ / : , �.'" �C��/ � <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />