Laserfiche WebLink
� <br />�ERMIT APPLICATI� <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 vwvw.everetfinra.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: , PROPERTY TAX it PE MIT # <br />3��3 �w�sfi Cr���Nv ���d ��fU--��:� •? �,U� 1 U c�� ����.uv I� I►--�1��1- G�( <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER I'� C��^i C� Covv��c� r( <br />Address �� �i U �c ��� ()� �� �. r- Oq <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip �0.-1�(Q j t/L�/� / � � � Z <br />PPLICANT: _ Owner _ Owner's Agent ✓ COf1ff8CiOf _ COf1tf8C10f�S A90flt _ T8�211i (must provide a letter of consent from the owner to do work in the space) <br />ONTRACTOR Ci S C c:.� , i-� �r o _ c'h o,�l L& I Lic. #(..OSC-7� � P( I O N 1'vl COE Bus. Lic. # Z�I l�� <br />•T: .�,,. _ .; �._ . .,. � q <br />dress LI�G� S� I�I S-f ��Q� <br />� �,1 2. i rv Fl �(� (►t(� G ti� <br />7 � <br />BUILDING PERMIT APPLICATION <br />; Phone/Email Zu ��- �� 3�5 -- 3 3�, v <br />CONTACT FOR PERMIT <br />`+_ � , 3 �� <br />Phone/E-mail � �' v _ � � �) — � U <br />CONTRACT PRICE OF WORK ��1 �p� �'a_ <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building CN��''{'�� F�u�'�� Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family 'r Commercial <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 />(.(�S( v F-i r{� ��c� �1-C c� b r� 7'O �2S ia� u Nd i NS �Jc. �� c� O.i`-e w �n.�-t �� n)v� wr ��{sr civ�. <br />e�- a o,�.� N� P/� �i. t`S - Z 6� v � G r F��-� G.ru Q-1� � v� I o1-� '� S�t-�-.����, �t s � a,,.r d�� �= m <br />Cy. !, v ac.. � �Cr; rt vv� e.r.i tS -�o � -�-.d rYfiw G v�-; l l.a��f —� Gc c� i l��f�. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fxtures <br />A/C - air handling units <br />Forced air svstems <br />Water heater <br />Gas fireplace <br />Gas ranpe <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />' (\1 Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of �xtures <br />Toilet <br />Bathtub <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow <br />Urinal <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify th 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 s cified rein or e ranting 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 au orized y e o er hi 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 />1J� <br />9-l� -�� <br />Owner Authorized Agent Si nature Date (Revised 6/2012) <br />