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 />SITE ADDRESS: PROPERTY TAx # PERMIT # <br />����c; �v'�r-mc��. ��� ; �.�L�:�r--i Ct��SI��.�S�i7 � l C-I �V" -C��� <br />LEGAL for new construction: Short PlaUsubdivision }� �- '`�� Tu �"" Lot No. (attach copy of long legal description) <br />OWNER ��fl'�K- �- 1�,�-1 G�"—% Phone/E-mail ('7-�S ��I�7' � SLrr`�� mkcti Ff���. {�r'unt��'�" <br />Address � r' �'� � � 1� L= � � Z�' Si City/State/Zip IC I tZ I� L- 9�7�1 � � V•' l� `� �': C��� <br />APPLICANT: �Owner _ Owner's Agent _ Contractor _ Contractor�5 Ag2flt _ T2f18�1 (must provide a letle� o( consent from the owner to do wo�k in the space) <br />CONTRACTOR <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />City Bus. Lic. # <br />IPhone/Email <br />CONTACT FOR PERMIT ,� <br />;:•��' �1�-F� <br />Phone/E-mail �f�"1Y1 C � S i�c'�b � [ <br />CONTRACT PRICE OF WORK '� Z� C 0 t' <br />Exisiing Use of Building Si l� �--� L E- fi�1'n � L�/ HEAT SOURCE: <br />Proposed Use of Building �� I�C�TL-L= "` Fl�-(1'1 I L-`� <br />Building type: V Single Family _ Duplex _Townhouse _ Multi-Family _ <br />Type of project: New Addition �Remodel Repair _ T.I. _ Sign <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Ni� ��' I>i� �� �a��i �_ j:_i'�CI-t1=N �A� i i�ET S <br />� <br />N��• P,���'i-t�'�C.;r�, <<� t� Zr� �� o��,�- <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: � New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i A/C — air handling units <br />i Forced air systems <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 />i Refrigeration <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSiEM <br />, Number of Heads <br />Gas <br />Other <br />Commercial <br />Sprinkler Demolition Chanqe of Use <br />� jL`�--�� �� V i'1'� F� i I�C'�- �+ <br />PLUMBING PERMIT APPLICATION <br />of Project: •3 New _Addn �Alteration _Repair <br />Show Number (#) of fixfures <br /><�Z- i Toilet <br />� ; Bathtub <br />•,2 j Lavatory (wash basin) <br />1 <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other ` - <br />A 1 <br />J����l,�,^� r.�.��'.'_`, <br />Other: <br />I hereby certify that I have read and examined this app�ication 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 propeRy to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/ ! :1 � �I a� <br />ll�.�-L�/ ��_ � ;c,,c,;:_,��,_,,,a� �, - / � S� <br />Owner/ thorized Agent Signature Date (Revised 3/2013) <br />C c,�-, <br />