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 />TE ADDRESS: �: �J��;/ � t�� ��r � 5 � _\ <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER � f=�C.�` �'�U V SIj�;�1 ,�a�C � I}{ fc �� ( <br />Address �' � �'�- G �=` �-�`� ��� ' <br />APPLICANT: _ Owner � Owner's Agent _ Contractor _ <br />CONTRACTOR Gl-' '�r{-C. SI-� ��C�`�`j� , <br />Address SC�I �t'-' `l 1� � � ��� �� • ►\,� : <br />� C' �' i�-1� j�`> C_ ���iCF- d�-(�� `.� <br />BUILDING PERMIT APPLICATION <br />PERTY TAX # <br />PERMIT # <br />�"% I z� i��c�r �� I�-f Z_ <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />�City/State/Zip �,� ���' (i��J4 �� � � � <br />Contractor�S A90flt _ T0f1811� (must provide a letter of consent trom the owner to do work in the space) <br />State Lic. #�/��.,^�o1-E CC,'3`f D �( City Bus. Lic. # <br />Phone/Email <br />(:UN I A(: I hUK I'tKMI I�� ���� ,'l� �1,� L i��S <br />� ��r <br />Phone/E-mail 2r.. �' �; �Z' > i i (j � ���Z'1 �l I ( (i� l'� 5%21 I`���, <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New Addition Remodel Repair _ T.I. �[ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />ni2 ��� I�� VI j L� I�n-� ��i� C� I�11� # I <br />I� <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 />i Gas fireplace <br />i Gas range <br />� Clothes dryer <br />� Range hood <br />( Exhaust fan <br />Heat pump <br />Unit heater <br />; Boiler <br />( Refrigeration <br />I Woodstove <br />i Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYS' <br />� Number of Heads <br />PRICE OF WORK <br />G� <br />Commercial <br />�Sprinkler [ <br />HEAT SOURCE: <br />Electric Other <br />olition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />I Lavatorv (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 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 thorized the ow this roperty to perform the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br />G � ��� <br />Own r/Authorized Ag t Signature Date � (Revised 3/2013) <br />�� Z <br />