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 /> SIT DDRESS: PROPERTY TAX# P R I ^l <br /> (0 ) (r c 1--c • ( -,,.0 lac q 00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> t <br /> OWNER Rt.) 6 SC___ Phone/E-mail <br /> Address E1 City/State/Zip <br /> APPLICANT: )owner _Ownecs Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 0_2')y'7 State Lic. # City Bus. Lic. # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 2,5 /q 7 <br /> Phone/E-mail a <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building kick- P'1 HEAT SOURCE: <br /> Proposed Use of 9uilding V) C�"7LQ_ Gas_ Electric Other <br /> Building type: ✓Single Family _Duplex Townhouse Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolitio Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> PF vno a(4-0►r2 <br /> /c -p ,ce ure <br /> 76K <br /> MECHANICAL PERMIT APPLICATION PLUMBING ERMIT 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 j Lavatory (wash basin) <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan ! Sink(service/bar/mop/etc.) <br /> Heat pump j Backflow preventer <br /> Unit heater _ j 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 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. <br /> AL 1 Cl v1I tri 2Z&\ 33 <br /> 0 ner/Ruth• zed Agent Signature Date (Revised 3/2013) <br />