Laserfiche WebLink
� <br />PERMIT APPLICATION <br />BUILDING/MECHANICALlPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar S�, Everett, WA 98201 425-257-8810 FAX 42�257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEP'TED FROM 8 AM TO 4 PM <br />ADDRESS: PROPERTY TAX � PERMIT 1t <br />,t4 k►�.T►•iarif �olr.. �,�t�r•°-�'�1" 9�2+�1 o���Sf���ol��l L1310 �D[?i <br />for new conshuction: Short Platlsubdivisan Lot No. (attach copy of bng legal description) <br />t�►�1'�.� �{tii�.is1�ly l�1�'i'ylY Phone/E-mail TZ�.� I� �• l�1�. <br />"$ Zz�i 1./�°tC+�l �✓t�' /0a1�.,. , crty�stacelzP �M�i��'t"f'. !� 4 �'�� � <br />� Owner _ Owners Agent _ Contractor _ Contractors AgeM _ Tenant �rnu� pwde a iemr or � eom n,a o�ner e do � ti n,a �) <br />�� <br />T,�,J� �� <br />BUILDING PERMIT APPLICATION <br />&ILiC.# 4�� <br />� �`��� ���t►�901� <br />honelE-mail ¢ p�',;;�T <br />;ONTRAC'I' PRICE OF 1R <br />��0���'lf,� � ��qa <br />�uQ�vr?" �,�.�s� A�Oo <br />L��'��+A���hi1�6i6,"1". �,a!t�� <br />:xisfing Use of Buil�ng Y. �� �+. � HEAT SOURCE: _ <br />'roposed Use of Buildinq '� ��, �. + Gas Electric� Other <br />tuilding type_ � Single Famiy _ Duplex Townhouse _ Multi-Family _ Commerciai <br />�ype of project New Addition Remodel Repair 7.1. Sign Sprinkler Demolfion Change of Use <br />1ESCRIPTION OF WORK (add'dional space provided on the badc) : <br />l�,l�°?�����-, ��P�o�vs,�';"�g:dea : '=°-�►`���� ��1�,"i'�r•� �1�°�r��?;�9 `�-:�:�'�e��"�, 6�1dn�"�x*� �,aa�+�, ��.�ar,;�"r <br />E�si'�Trr�::� ���12w��+� `�a 161�E���', �A"�i�l, N��► ��°��.t,a.l�,. � }�en�ie�lF=� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New Addn ,�C Alteratlon _Repalr <br />Show Nuenber (� of ilxtures <br />� A/C – air handling units <br />I Forced air svstems <br />Water heater <br />i� <br />of <br />PLUMBING PERMIT APPLICATION <br />of Project New Addn ,�i Altaration _Itepalr <br />Show Number (!y of flxtures <br />Toilet <br />/ Bathtub <br />�— Lava wash basin <br />/ Shower <br />� —� Kitche� sink 8� disposal <br />� � Dishwasher <br />� Clothes washer <br />j Water heater <br />J � Sink (servicelbarlmop/etc.) <br />Badcftow preverrter <br />Urinal <br />� Drinking Fountain <br />j Floor drain <br />� G� � <br />` Roof drains <br />I <br />I Medlcal Gas <br />i Other. <br />� Other: <br />I hereby oert�y tl�at I have read ard exami�ed S�is a�cafon m�d loww the same 6o be true and conect A1 p�ovisions d lews and ads�ar�ces govertiig tl�is lype af walc w1 be compiad <br />wilh NAieUier spec�d hereii or nd. The granting d a pertrit does not ptesisne b give auB�orily lo viol�e or canoal the prwfeion of arry otlter slate or local law regulatlng cor�shuctlon <br />That 1 em ault�orized by the wrner of this pioperty b peiiam tl�e wak for which appica6on is made and I comply wih the S�e Conbadors Lew 1627 RCW and 296200A WAC. <br />/�- z �-� 3 <br />owoer/a�rtnorized aeent signat�re Date <br />�r���a sr2o�a� <br />~�Z <br />