Laserfiche WebLink
• <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 />SITE ADDRESS: ��6 '� 3i� %��C PR�p�pp3p � 6a0Z0� P�//�✓.� "�G' <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER �q {rn�iZl �l/ '�1 (9 ��- <br />ress � (� <br />CONTRACTOR <br />, . 3 �"l f9 �� <br />� �,;:, :-�-, , <br />NT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail �� 2 3 p 3b�0 <br />City/State/Zip r1/���1 ( , VVrJ -/ ���3 <br />L&ILic.# <br />IPhone/Email <br />ONTACT FOR PEI�MIT <br />� � % _ �l,�vr�f b�` <br />ione/E-mail 'r�� ��� �(�� � <br />ONTRACT PRICE OF WORK <br />Existing Use of Building �V Y LE� HEAT SOURCE: <br />Proposed Use of Building � � pLEp GasN Electric Other <br />Building type: _ Single Family � Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition � Remodei _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back) : <br />��l (/ � ,���y.�-i �� N� <br />Have you started working without a permit? _YES �NO <br />MECHANICAL PERPJIIT 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 />� Gas range <br />Clothes dryer <br />� Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />I Refriaeration <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 & dispo� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moK <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 <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 perform the work for which applicat� "n is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC � fZ <br />� <br />������1, �; �:� ����� ��� ��� � �'� <br />Owner/Auth ized Agent Sig'�n ture Date (Revised 2/2011) <br />\ � <br />