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 />ADDRESS: � PROPERTY TAX # PERMIT # <br />yi�'I(�� ��{-G��GC� l/llaVl �-� ��3�132002o/(oov �71�''�A <br />3AL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />'NER (/�/ ���h��.SG� � l �G/ Phone/E-mail <br />�ess .�� � S r'C IrC �� 1-�e h Wic-c.-o City/State/Zip �Yi'-rt f� �'7 8'�D 3 <br />LICANT: _ Owner _ Owner's Agent V Contractor _ Contractor'S A90fli _ T2f18f1Y (must provide a letter of consent hom the ownei to do work in the <br />4CTOR �J�vv � ,S/� ti S s I�+� 5 State Lic. # I]�12��ss i%S] C37City Bus. Lic. #,,( �, <br />7� (i� '�la �'(%I"�� D '^ � D� � �12 K � 9 0 � �j' Phone/Email �Zrj � % � O �f,3 S <br />INre�rc� S �� � ,�tul <br />BUILDING PERMIT APPLICATION <br />,B� �� t � a bS <br />Phone/E-mail <br />CONTRACT PRICE OF WORK v?, no 0 <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair T.1. Si n Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provrded on the back) : �, <br />--l�isf-tcl1�2 il(I.tw�r'rlatftd Sr'Jh Cncb��rt�S �AS�2j1 bl� j..f<S7 �`-C�/Ct D <br />„ , J � h <br />-� `Y�S��II (� �' Cish GA�i'�cf C o�-, �1Cry-r„ � �-P���rOh <br />.' F,�,mcvL �ci ti��rc. Cau'�1 �✓l�1 � �a�`r�iv��� �s��C �� � �rlc� rQ�n(�+�� �,.; i f� :-r,�:.li ,5 ��>1 . <br />MECHANICAL PERMIT APPLICATION � PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number # of �xtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Unit heater <br />Boiler <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Toilet <br />Bathtub <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and conect. All provisions of laws and ordinances goveming this type of work will be comp <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 property to perform the work for which appl'cation is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� � ��- � .r,� ��3 /S � . <br />Owner/Authorized Agent U gnature Date (Revised 9/2014) �� <br />