Laserfiche WebLink
��(� � � � � � � ���e,r►,e�e. <br />� <br />PE MIT 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 />)DRESS�W� �� ,IL'S��LIS 1/1[, ��t'Y I�PU`f j'-'��t`� �Q��� I P� �� � Z' L!�Z <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />. � _ 1 � _ <br />OWNER �: <br />Addres�0 <br />APPLICANT: _ <br />CONTRACTOI <br />4ddres <br />TENANT BUSI <br />o . <br />Phone/E-maii <br />�/�� / rv�L'. UK ` l S �t�iryi�cace�u� l L0. �'Lm l G� Z <br />Owner _ O�nmer's Agent �ontractor _ Contractor�S A9Bf1t _ T21lHf1Y (musl provide a letter of consent lrom 1he owner to do work in the space) <br />0 <br />� <br />� Lic. # �}Q <br />Phone/Email � <br />TACT FOR RMI <br />n��e �� <br />Bus. Lic. <br />ZD,b ?S� `-�� <br />BUILDING pERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building HI <br />Proposed Use of Building Gas <br />Buiiding type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />T e of ro ect: New Addition Remodel Re air T.1. Si n S rinkler Dem <br />DESCRIPTION OF WORK (additional space provided on the back): ��I C�. <br />J <br />MECHANICAL PERMIT APPLICATION <br />Type Project: _New _Addn _Alteration _Repair <br />Show Number (#J of frxtures <br />A/C — air handling units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fireplace <br />Clo s dr <br />Ran e <br />' Exhaust fa <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratic <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPli <br />Number of I <br />Other <br />of Use <br />PLUMBING PERMIT APPLICATIION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of /ixiures <br />Toilet <br />Bathtub <br />Lavatorv (wash basin) <br />�nower <br />Kitchen sink & disposal <br />Clothes washer <br />Water heater <br />Sink (service/b2 <br />Backflow prevei <br />Urinal <br />Drinkina Founta <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certrfy that I have read and examined this applica6on and know the same to 6e true and correcL All provisions of taws and ordinances goveminp this type of work will he comp <br />with whether specified herein or not. The granting of a permit does not presume to ive authority to violate or cancel the provision of any other state or local law regulating construction <br />at m authoriz y e o ner of this pr y to perform the work for hich app ation is made and I compry with the State Conhactors Law 18.27 RCW and 296.200A WAC. <br />O o e A nt ignature te (Revised 9/2014) <br />