Laserfiche WebLink
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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a' Q / 11 <br />SITE ADDRF55: _ � <br />PE lY $1 <br />P <br />O l Ova <br />6? .5z I ✓L �'L` (loll <br />I <br />LEGAL for new construction: Short PlaVsubdivision Lot No._ (attach copy of long legal description) <br />OWNER e-N:1 gc 4Eie %=C -`� Phone'E-ma:l IG. ('o -3 �,Z- - )S IS <br />,2 � C k-e I <br />Address 5' I 1-> yd-v-L L�-VID City/StatelZip GI <br />l <br />CONTRACTOR 1 CHUdo er,,lT-9-ACT�'� L8ILic.# t MLC.HCL 101i <br />Address G ,j�Y. Z,:: 7Phone/Email 2'� 3' Cq O ) % (!, <br />- ' S- <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT(2Cl;� i A tta x le,q (X'e <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK / G1CC, C G <br />HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building Gas__ Electric _ Other <br />Proposedtype: <br />Single Family _ Duolex _Townhouse ✓Multi -Family _ Commercial <br />_ <br />Type of project: _ New ,_ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolitlon_Change of Use <br />Description of Work (additional space provided on the back): <br />rC' F- <br />12 C C.c c A T Zv--f G F 6143 <br />Have you started working without a permit? _YES __NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now,_Addn _Alteration _Repair <br />Typo of Project: _Addn _Alteration _Repair <br />_Now <br />Show Number(p) of fixtures <br />Show Number (0) of fixtures <br />A/C - air handling units <br />Toilet <br />_ <br />air <br />Forced air systems <br />Bathtub <br />Lavatory(wash basin) <br />Gas pi <br />_ <br />Shower <br />Water heater <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />_ <br />Range hood <br />Sink (serviCL/bar/inop/etc ) <br />Exhaust fan <br />_ <br />Backflow, prevenler <br />Heat ump <br />_ <br />Urinal <br />Unit heater <br />__ <br />Orinkln Fountain <br />Boiler <br />_ <br />Refrigeration <br />Floor drain <br />_ <br />Woodstove <br />Grease trap <br />Roofdra'.is <br />_ <br />Duchn <br />_ <br />Other _ <br />Medical Gas <br />_ <br />SPRINKLER / SUPPRESSION SYSTEM <br />_ <br />Other <br />Number of Heads <br />I hereby certify that I have read and examined this application and know the same to be true a.id correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether speared herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or loral law regulating construction or the performance of co,,struction. That I am authorized by the owner of this property <br />to perform }pc work for which application is made and I comply with the State Contractors Law IS.27 RCW and 295.200 WAC <br />(Revised fYt0f0) <br />Ownar/Auth zod Agent Signature Data <br />