Laserfiche WebLink
CJ <br />• <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE A <br />�f���2'. <br />LEGAL for new construction: Short PlaUsubdivisi <br />OWNER <br />Address � <br />CANT: _ Owner _ Owner's Agent <br />CONTRACTOR <br />�! <br />��! %�r�2� � GR�20��01(0 <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip <br />Contrector � Contractor�S A90flt _ TBflOflt (must provide a letter of consent from the owner to do work in Ihe space) <br />L & I Lic. # <br />COE Bus. Lic. # <br />�'�� IPhone/Email <br />CONTACT FO E IT <br />�U� U t kie.��s _L� . <br />Phone/E-mail �'� , �4,�``�R _ �J ��c <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� c7C7 <br />Existinq Use of Buildinq S r^ <br />Proposed Use of Building S 1^ � <br />Building type: V Single Family _ Duplex _Townhouse _ Multi-Family _ <br />Type of project: _ New ✓Addition _ Remodel _ Repair _ T.I. _ S <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />Q' x a�' �f4 r-�c.�eN �- � r N i N� <br />8' x a�-� I'Yi p�eCZ l�e�l!'�om a-�3�h . <br />MECHANICAL PERMIT APPLICATION � <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 range <br />I Clothes drver <br />SPRIN <br />Exhaust fan <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />/ SUPPRESSION SYSTEM <br />Number of Heads <br />Commercial <br />S�rinkler <br />HEAT SOURCE: <br />�Electric Other <br />Chanqe of Use <br />0 <br />PLUMBING PERMIT APPLICATION <br />Type of P�oject: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />; Bathtub <br />Lavatory (wash basin) <br />� j Shower <br />J Kitchen sink & disposal <br />/ Dishwasher <br />i Clothes washer <br />i Water heater <br />! Sink (service/bar/mop/etcJ <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify at I ha�ie 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 />wi ether ecified he�ein 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 />hat I am aut r ed by th� owner of lhis property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200H WAC. <br />uthorized Age�t Signature <br />� l8 �a <br />Date <br />(Revised 6/2012) <br />�lz <br />