Laserfiche WebLink
� <br />�ERIlIIIIT APPLICATI e� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />for new construction: Short PlaUsubdivision <br />PROPERTY TAX # <br /># <br />No. (attach copy of long legai description) <br />� <br />ER Phone/E-mail Zy-3Q����� <br />;s � City/State/Zip �j/�� �� R � <br />ICANT: Owner _ Owner's Agent � Contractor _ Contractor�5 A92f)t _ Tefl2flf (must provide a letler of consent irom the owner to dp work In the space) <br />Address <br />BUILDING PERMIT APPLICATION <br />State Lic. # nJ {f�1�� City Bus. Lic. # Q���� <br />��3 Phone/Email �LS— n�� �� <br />CONTACT FOR PERMIT �� j� Q„_,����� <br />�v-rU <br />one/E-mail /-�Z-�j- �7, <br />)NTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building Gas <br />Building type: ,� Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel _ Repair _ T.I. _ Sign _Sprinkler _De <br />DESCRIPTION OF WORK (additional space provided on the back) :�'�ST�9'LL � Il%P-�N <br />�u►-►tiP 5�sr��''�- • <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 ranae <br />lothes dryer <br />ange hood <br />xhaust fan <br />eat pump <br />nit heater <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />EleCtfic /� Ot <br />nolition_Change of Use <br />17�,{G-Tt�ss ��ct-r- <br />of Project: _New _Addn _,Alteration _Repair <br />Show Number (#) of fixtures <br />1 Toilet <br />5nower <br />Kitchen sink & di <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know ihe same to be true and correct. All provisions of laws and ordinances governing lhis 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 />ihat I am a thorized by the owner of this property to perform the work for which application i made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />��i[�.0����i/// o ���7//.� <br />(Revised 4/2015) <br />