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 DD ESSL: _ _ _ _ PROPERTY TAX# PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> vt/ <br /> OWNER "� � `1� Phone/E-mail ,/� ZZ/N lryl ,;: C/'��LJ <br /> y� , ' <br /> Address U j ��4 ' " City/State/Zip V_, L t I J <br /> APPLICANT: Z 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 State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <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 X Duplex_Townhouse _Multi-Family —Commercial <br /> Type of project: New Addition Remodel X Repair XT.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WqRK(additional space provided on the_back): <br /> Yv f f ki-A`r-)/U? � X (S77 4/(; 6e`i 2f`106� / c,vo r r< P <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 /> I Forced air systems Bathtub <br /> j Gas piping j Lavatory(wash basin) <br /> �( Water heater j Shower / <br /> Gas fireplace Kitchen sink&disposal <br /> j Gas range AA, i Dishwasher <br /> Clothes dryer [ Clothes washer <br /> Range hood <br /> Exhaust fan }C ! Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> I Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 governing this type of work will be complied <br /> with whether s ec'fled 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 thorized by the own 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 /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />