Laserfiche WebLink
• <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/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 />SITE ADDRESS: PROPE � TAX # PERMIT #. <br />��l'0 �-.��'-�e�,..,� ) �- , ���L-c� � �'.��'r--) �"4��'J���''.��_.`- : rj ��-jCj� -��� 1 <br />LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />�'�.A� � � 1 0 4-7 �. - �� �1 <br />OWNER � �.nr'�t�}_"�� �'. �.� ��9�, ti.:'��...�_���E_,-� PhonelE-mail C�. r�1oMGi.re�'�rz°1<'��G'�t�fc��1P.(eC'.A� <br />addres5 Lv ��;, (,�v`r v� � J%.. F� City/State/Zip � 4l�Klc,✓[x�p (,�f fa '��} ,� .� c;� <br />APPLICANT: Owner _ Owner's Agent _ Contractor _ Contractor�5 A9eflt _ T8f1211t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR '"`�"'�"` State Lic. # City Bus. Lic. # <br />Address ` � � Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT Z� �_ -�� g—� q�,-� <br />�' n� � J��'� a �� � . . r �-J ,�: j ,, � <br />�,. ., � � , .., <br />Phone/E-mail , � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK [ L '.00J <br />Existing Use of Building '�e-Sl ��'-�'� ` ��- `. .5 �,` HEAT SOURCE: <br />"'_ 6-. � <br />Proposed Use of Buildln �� �-� � S Gas Electric Other <br />Building type:'�ingle Family Duplex _Townhouse _ Multi-Family _ Commercial <br />�...�d a...��.:._. . . _..:,..: � <br />Type of project: _ New _ Addition _ Remodel _ Repair � T.I. _ Sign _Sprinkler _Demolition_ <br />DESCRIPTION OF WORK (additional space provided on the hack) : }., <br />�t. /� �'V (�. �,. �.l'... 1- �.-�� C..f�, ���r� P 4/� f__ ��1. l �? � 1 �'. �� N..i -� W- �.:� � M. 1 A.) Q T.r:�. <br />r _ -�1 .! r <br />�fy; ,, * <br />� , . . ' <br />. �' <br />�y._ - f''��-'�'%�..�.F.1�._ �.�,.L':�A.,i` c.. , � � ., . . .. W.-:tf�s`�p'.r � F�... �' .. . s.,;_'".�� '�_�. �r,,e�_t� <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I A/C - air handling units <br />( Forced air systems <br />Gas piping <br />Water heater <br />i Gas fireplace <br />I Gas range <br />! Clothes dryer <br />� Rangehood <br />� Exhaust fan <br />Heat pump <br />� Unit heater <br />, Boiler <br />� Refrigeration <br />� Woodstove <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />, Number of Heads <br />Chanqe of Use <br />ra�-����_ .� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />! Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />i Water heater <br />; Sink (service/bar/mop/etc.) <br />! Backflow preventer <br />I Urinal <br />j Drinking Fountain <br />� Floor drain <br />� Grease trap <br />I Roof drains <br />� Medical Gas <br />i Other: <br />! Other: <br />I hereby certify thal 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 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 application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� 2 �I �� c?�—zd �/�' (/Z, <br />� <br />Owner/Autfiorized Agent Signature Date (Revised 3/2013) <br />