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 />,� j=�� y c��z�,s ���;� �'�- c��� 9�, <br />LEGAL for new construction: Short PlaUsubdivision <br />TAX # <br />PE MIT # <br />� I �-,( �� �-% -�.� � � <br />No. (attach copy of Ibng legal description) <br />Phone/E-mail <br />jdress ICity/State/Zip <br />PPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�5 A9ellt _ Te�BfII (must provide a letter of consent from the owner to do work in ihe space) <br />ONTRACTOR _��ru;Ti�iillL°��� L�72C ��r State Lic. #��� -Sc"�/��J�D,�I�� City Bus. Lic. # Q,j `�,3� <br />jdress � y%� / .�, Gt% • %r �1�,A .S� �G�_ ��'%� �� Phone/Email �t p ( --93c? ' � � 7 / <br />:IVHIV 1 �UJIIVCJJ IY/11 IC ' <br />/—;�'!��l,{i�, lL ( ��� �'�� <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail �tJ �� � �� <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building � <br />Building type: _ Single Family _ Duplex _Townhouse 4-Multi-Family _ Commercial <br />Type of project: New Addition _ Remodel Repair _ T.I. _ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additional s ace rovided on the back)' <br />3 _ 3� �� <br />HEAT SOURCE: <br />Electric� Other <br />�molition Change of Use <br />P A /JG�/�- .I �C/H.3 -�U7� 2 �.✓ � � <br />� � � <br />�c� �-�c�� �' �� % �i��,,� ���`�r^� . <br />�u / � :S� G/�-/� �� � � �i � � �/� O� -�z ��r�s :�,�.. � r � �z/.�-��� <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 oipina <br />SPRI <br />vvater neater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />ER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Altera <br />Show Number (#) of fixtures <br />� i Toilet <br />,� `� Bathtub <br />0 <br />Clothes washer <br />Water heater <br />esacKriow prevent� <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />n��`-itepair <br />in) <br />�sal <br />0 o/etc. ) <br />I hereby certify that I have read and examined this application and know the same to be true and correcl. All provisions of laws and ordinances governing this type of work will be complied <br />with whetherspecified herein or not, The granting of a permit does not presume to give authorily to violate or cancel the provision of any other state or local law regulating construction <br />T I am uthorized by the owner f th prop �ty to erform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />/ � <br />, iL�(,��� ` �ti'"!/ " "� �-_. <br />ner/Authorized Age t Signature Date (Revised 4/20i5) <br />