Laserfiche WebLink
0 • <br /> PERMI.T.ARPLICATION <br /> BUILD1 NG/MEC HANICALOLUMBI /D <br /> Nd/SIG KLEREMOLITION <br /> CITY bF-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 /> SITE ADDRESS: PROPERTY TAX# Pr mT <br /> .# �- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER r L Phone/E-mail <br /> Address L/-/e �/�w City/State/Zip �I/zE::rz t (N - <br /> APPLICANT:_Owner _Owner's Agent 4Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR � Sr-i_;4 T 10 J,5 L&I Lic..-# 1S 0L-&L w < COE Bus.Lie.# e� 2& 111 <br /> Address Z'j0U �T t S; SvJ � Nrv.J Uw� i� t Phone/Email -42Lj <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> b�U lb 73obm-ce- I I �l ^ 1 <br /> ` Phone/E-mail Zj - 14 4P -r- dui dC',lbsziLJ 10 i P1 kJ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building -t tc HEAT SOURCE: <br /> Proposed Use of Building L-tZ Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X 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 /> I ,0—cr--) S 7"r. /-k e,1, W'! v--)---T-1 oN �0 r- CH <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 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 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 /> 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 pro 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 /> ner/Autr ed Agent Signature Date (Revised 6/2012) <br />