Laserfiche WebLink
( <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLI110N <br /> CITY OF EVERETT PERMIT SERVICES �� I 3-��'Jt, <br /> 3200 Cedar Sl., Everett,WA 98201 -425-257•8810-FAX 425-257-8857-www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: _� PROPERiYTA%N P MITN ' vO� <br /> a � � � <br /> LEGAL lor new construalon: Snoe Plavaubdirieion Lot No._ (allech copy ol lonp lepal descdpllon) <br /> OWNER Ir '�l Phone/E�ma11 <br /> aarees a � (,f _- ciryisie�dtip �/� � �v � <br /> CONTRACTOR � - U<<u� L81LIc.N S L `y- —7p'��+-) <br /> `v0 � � / G `G, � �Jv� PMi�elEmall � /�" / 0 0`� <br /> Addreis p v <br /> TENANi BUSINESS NAME CONTACT FO/R P�ERMIT as"TSv"7�S <br /> P�one/E�mall �./' WNN \��-� S�WU. (yQ- i 0. �/ <br /> � ���� <br /> BUILDING PERMIT APPLICATION cON7ruCT PRICE oF WORK — <br /> Exisling Use of Building <br /> HEATSOURCE: ��� <br /> Proposed Use of Byilding Gas eiectnc omer <br /> Building type: ��Single Family _Duplez_Townhouse _Multi-Femily _Commerciel <br /> Type ol pro�ect: _New _Addilion �Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Chenge ol Use <br /> De4Cfipllon ol Work(edCihonj1�`space povided on Ihe�ack)' �� V�^�� <br /> V����;rc� `Xs�wJ�Nq I N 5i�:lP c b a�n C'�� � o�' I� <br /> � J <br /> Have you etaAed working withoul a permil7 _YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT PPLICATION <br /> Type ol ProJecl: _Naw_Addn _Alterallon__Rapelr Typa ol ProJacl: _New_Addn _Alt�ntlon_Rapalr <br /> Show Numt er(M1 0l llifuree Show Number(NJ of Orfuna <br /> A/C-air handlin unils Toilet <br /> � Forced air s stems Bathtub <br /> Gas i in Levato wash 6asin <br /> I Waler heater � Shower <br /> � Gas fire lace Kitchen sink&dis osel <br /> Gas range Dishwnsher <br /> Clolhes d er Clolhes wesher <br /> Ran e hood Waler healer <br /> [�haust�an Sink service/bar/mo /e�c. <br /> Haat um Backflow reven�er <br /> Uni!healer Urinal <br /> � Boiler Drinkin Founlain <br /> Relri eration Floordrain <br /> Woodstove Grease lra <br /> Duc�in Rool draine <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Other. <br /> I�ereEy cedJy thet 1 have reaJ en0 ecemined tni�eppli on an know t�e aame w be Ime an7 wrrect.All provieiona al lawf antl wdinencea 9ovemirp <br /> �Ns rypa of wort.will be wmplreA wiln w�et��:�peufie ereln o nol.The p�anlicp al a permil Aa�nM p�e�ume lo Oive euthonly to vioiate or cencel <br /> roviiion W ther el pr loc I row requlat�ng nstru n or the paAormence ol construciion.Tha�I em authoezed by Ine owner ol�ms proparry <br /> � In pw1 �he wo� k�a itet n n maCe en I mmp wiln the la�e Con� ctore Law 1E Y7 RCW an0 YB8200 WAC <br /> �_�= - � _ � f � `Z- <br /> er/Authotlxsd A �nt S gn �ura . De (ReMaed 7/7��p <br />