Laserfiche WebLink
� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLIT'ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />E ADDRESS: l ST PROPERTY TAX # PE� MIT # ,� <br />�JO7 O IZUGK-��R ,�cvC. • Ob�'1jZS�%ZODZZDD 1:=) (�J�."-t"'OT� <br />iAL for new construction: Short PlaUsubdivision l7EG� �i�l"t�� Lot No. (attach copy of long legal description) <br />LICANT: <br />Phone/E-mail � L�j • �,�,�1 . <br />��j0gj ICity/State/Zip <br />Owner's Agent _ Contractor _ Contractor�S A9@f1t _ TBIlBflt (must provide a letter of consent from the owner to do work in the space) <br />L & I Lic. # <br />�ZO'� <br />M�5 �{ �t-�-�-�- "��-�r.� � �-r- <br />BUILDING PERMIT APPLICATION <br />COE Bus. Lic. # <br />Phone/Email �6�/ f ) , G-,! �h . <br />�ru i ' <br />. �f;f�%_ �1�-r�,� <br />PRICE OF WORK �ji �D?� <br />Existing Use of Building �1��� � <br />Proposed Use of Building �7A�M�, <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair � T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />HEAT SOURCE: <br />� Electric Other <br />olition Chanpe of Use <br />1�1�JiA�I.�. �A�Z-T1 T'l a k�l `�'D G(Z,E.L�T� C2� f7� �G�cS • C IJ�iL!-l�c.— ►J E� pot�� �, <br />�P��JC�E F��"� D�'� ��tt��' T� CA►.� �.�N GE (2pp N( <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATI�ON <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />vvater neater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <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 lo be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specifed 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 regula[ing construction <br />That I am aut zed by the owner of this property to perform ihe work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />0 <br />� � �3 ��/ � <br />wner/Auth ed Agent Signature Dat (Revised 6/2012) <br />