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 DDRESS: a PROPERTY TAX# P•RMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER '^���.(, f 1�,' pwt o c-Aalyc Phone/E-mail <br /> Address 7 �+ L City/State/Zip <br /> APPLICANT:—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 /> j`i� �--� <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 Electri her_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial J%r <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 /> 'De me ow b i,I e �/vo rel,° <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 j Bathtub <br /> j Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> j Gas range j Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood j Water heater <br /> j Exhaust fan j Sink(service/bar/mop/etc.) <br /> j Heat pump Backflow preventer <br /> i Unit heater j Urinal <br /> j Boiler Drinking Fountain <br /> j Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting j 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 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. -21` <br /> O er uthorized Agent Signature D e (Revised 3/2013) <br />