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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: /J PROPERTY TAX# P MT# O <br /> -� , <br /> LEGAL for new construction: Short�Pll/at/subdivision Lot No. (attach copy of long legal description) <br /> OWNER /(I'LL"!�/d�(' � ( L G <br /> LPho/nelE-rnail <br /> Address e/Zip <br /> APPLICANT:—XOwner _Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter ofconsent from the owner to do work in the space) <br /> CONTRACTOR Q L&I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONk -2u <br /> CT FOR PERMIT <br /> L e, _ <br /> Phone/E-mail �yZ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building L—,,2 HEAT SOURCE: <br /> Proposed Use of Building Gas_ ElectricOther_ <br /> Building type: )-C Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel epair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> r�--,PA r 5 i�i n� r,?.Pt i(- <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 /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range 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 /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I Other: <br /> Number of Heads 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 goveming 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 the owner of this property to perform the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/ thorized Agent Si ature Date (Revised 6/2012) <br />