Laserfiche WebLink
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' IZ <br /> PROPERTY TAX# PE MIT# <br /> LEGAL for new construction: Short Plat/subdivision <br /> ( }/�` Lot No. (attach copy of long legal description) <br /> OWNER j j IyA1� J,Y lS�/l <br /> Phone/E-mail <br /> Address S jt S & City/State/Zip' 2 <br /> APPLICANT:—Owner Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1 V � '� State Lic.#" L) _ C U J y us. Lic.# <br /> Address ' <br /> � )��j/ j A E.. Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �s3C � <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _v 0 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building CA. C 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 /> � qo-[9 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> j Gas piping I Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace Kitchen sink&disposal <br /> j Gas range j Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan i Sink(service/bar/mop/etc.) <br /> I Heat pump Backflow preventer <br /> Unit heater j Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> Ijz®) 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 w ether specified herein or not.The granting of a permit does not presu to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> Th am authorized by the owner of this property to perform the work for whic application is made and II comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owe orized Agent Signature D to (Revised 3/2013) <br />