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: PROPERTY TAX# PERMIT# <br /> 0 0 5j 1) 3 4o 6 iligo - <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �2k LL-C� Phone/E-mail aCIG 41 " <br /> Address 2 , City/State/Zip EJ Of � <br /> APPLICANT:A 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 c t - State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME` CONTACT FOR PERMIT <br /> r Cit ct'�i C, c[; - <br /> Phone/E-mail �c�(o "�{ f 1 y cI y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 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 /> 1 ns#-acf- TJ�� <br /> MECHA ICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Proiect: J 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 /> Gas piping Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range i Dishwasher <br /> ! Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove I Grease trap <br /> Ducting ! Roof drains <br /> Other ! Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads Other: <br /> 1 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 auth rized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Z <br /> ;rZjz� l3 <br /> Owner/Authorized Agent-SigpaAure Date (Revised 3/2013) <br />