Laserfiche WebLink
0 ! <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 /> SITE ADDRESS: 1PROPERTY TAX H RRM <br /> LEGA L for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 1 `M Phone/E-mail <br /> AddressIMO <br /> laovt City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's Agent A Tenant(must provide a letter of consent from the ownerto do work in the space) <br /> CONTRACTOR :4"r- State Lic.# City Bus. Lic.# `�q __8 <br /> Address j }ova �� At `� +t esu ,.j Phone/Email - _ <br /> TENANT BUSINESS NAME CONTACT FOR PE MIT <br /> ��,•n <br /> Phone/E-mail Lf — ZZ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Za <br /> n <br /> Existing Use of Building ,. HEAT SOURCE: <br /> Proposed Use of Building Cwt`,<,% mtl Gas Electric_ other_ <br /> Building type: _,Single Family _Duplex_Townhouse —.Multi-Family _Commercial <br /> Type of project: New Addition '&Remodel Repair_T.1._Sign_Sprinkler_Demolition_Change of Use / <br /> DESC FIPTION OF WORK(additional space provided on the back): <br /> A�In (Z) �C�Tt�1 X - >rI L1� '► rz NDr1 <br /> err <br /> l.� <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 Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace i 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 j Urinal <br /> Boiler <br /> Drinking Fountain <br /> Refrigeration i Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads I 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 authorized 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 /> 1�}(zi113 <br /> Owner/Authorized Ag t ignature Date (Revised 3/2013) <br />