Laserfiche WebLink
� � <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 />ADDRESS: r., , l �,/ IPROPERTY TAX # <br />_. 3 �: :�" �, .� s� S� =, 1 � <br />LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />OWNER ( �'J�`y'/ � ;, , -��,. .. c�t i .� /'' ��� C r� �:�i... � Phone/E-mail �/ � � � —, ��/.. � � � (; <br />Address � �;l�0 � � � ii �_ l�lC '�l�'_�le%,/�ta �� �'� C(; `j City/State/Zip �(j �c- �� e' t�L!:- �^/�l ';��' � �) ` � <br />APPLICANT: _ Owner _ Owner's Agent �Contractor _ Contractor�5 A92flt _ T2f18f11 (must provida a letler of consent from fhe owner to do work in the space) <br />CONTRACTOR � � •,�� ��� �,_,, ;.-� C r� . _� ; ��' . State Lic. # ���� �',"_,,:�'� �_� `_Z ,") � ` City Bus. Lic. # <br />/ � <br />Address � �y i �: � ��` <f /Z,� ti���..,r� �� -�`�-' � ���_ �� Phone/Email �d�� �"-� �� � ,, <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�/ �, - <br />I- ��-y_ <br />�" �,I �' �� c� ` �b Vi/Zj�� k�- r1 ,�i✓i�, Phone/E-mail <br />BUILDING PERMIT APPLICATION /;�.;����,�,:,.` CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show NumBer (#) of fixtures <br />� A/C — air handling units <br />( Forced air systems <br />Gas piping <br />' Water heater <br />! Gas fireplace <br />� Gas range <br />; Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />; Unit heater <br />Boiler <br />I Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />han4e of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _,Repair <br />Show Number (#) of fixtures <br />' a ! Toilet <br />Bathtub <br />� � Lavatory (wash basin) <br />� Shower <br />Kitchen sink & disposal <br />f Dishwasher <br />j Clothes washer <br />/ ; Water heater <br />�' � Sink (service/bar/mop/etc.) <br />( Backflow preventer <br />I Urinal <br />Drinking Fountain <br />j ; Floor drain <br />I Grease trap <br />� Roof drains <br />� Medical Gas <br />I <br />jOther: <br />� 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 permil 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 lo pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />_ � <br />� � = , <br />� � �� � '�r,- _ _ � �%���'� <br />Owne�/'Authorized Agent Signature Date (Revised 3/2013) <br />