Laserfiche WebLink
rERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMO�TION <br /> CITY OF EVERETT PERMiT SERVICES I�3� l I <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettw .org <br /> ApPLICATI0N8 ARE ACCEPTED FROM B AM TO 4 PM <br /> Z � <br /> - �ocY,nl�i 2 - io <br /> LECvAL lor new consirucllon: Short PlaUsubdivislon Lol No._ (attach copY ol long lepel tleecrlF��on) <br /> OWNER -}� �� � Phone/E-mell • 7 ' � <br /> Addrea6 Clty/S�ete2lp C Q <br /> CONTRACTOF - L 8 I Lic.# <br /> PhonelEmell �3 z 7- � � 6� <br /> Addrese <br /> TENANT BUSINE33 NAME CONTACT FOR PERMIT <br /> PhonelE-mall <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Q <br /> Existing Use of Building F�m� S� HEAT SOURCE: <br /> Proposed Use ol Building J�F2 Gee � Electdc Omer <br /> Building lype: �Single Faniily _Duptez_Townhause _Mulli-Family _Commerclal <br /> Type ol proJect: _New _Additlon �Ramodel _Repair_T.I._Slgn_9prinklar_Demolitlon_CA�nga ol Use <br /> Desc�iption of Wo�lc(etlOrli�nel space p�ovided on fhe back): <br /> G �NuEZT ,�f�s���x. 4,:e,4c;e /�rr� aEoao�M,i sa�nf.�r�� p w,��ny <br /> Hava you sUAed working wlthoul a permit9 _YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol ProJact: _Naw_Addn _Alter�tlon_Repali Type ol Pro�acl: _New_Addn _Allere�lon_,R�p�l� <br /> Show Numbar fM)ol llrfurea Show Number(M)olllxfun� <br /> A/C-au hand6n units Toile� <br /> � Forced eir s stems Bathtub <br /> Gas i in Levato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis ose� <br /> Gas ran e Diahwashe� <br /> Ciothes d er Clothes washer <br /> Ran e hood Water healer <br /> Exhaust fan Sink service/bar/mo letc. <br /> Heat um Beckllow revenler <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Relri eration Floordrain <br /> Woodstove Grease tra <br /> Duc�in Rool dreins <br /> Other _ Medical Gas <br /> SPRINKLER I SUPPRESSION 8YSTEM _ Other <br /> Number ol Heads �-- <br /> I hereby cehily Ihal I havo read and eMaminetl Ihle applicalion end know Ihe aame lo ba irue end correcl.All provlslons ol lawe enE ordinencae poveminp <br /> Ihle type ol work will be complied with whelher specllfed herein or nol.T�e p�anling ol e permil doen nol preiumo lo pNe aut�orfly�o vialBle or cancel <br /> Ihe provision ol any ol�er slata or local law regulaling construction or the pedormance ol conntiuctlon.Thel I em aulhodzetl Dy Ihe ame�af I�ie property <br /> lo dorm Ihe work lor whlch epphcation Is mede end I camply ilh Ih Stete Conlrac�ors Lew 18.27 RCY�end 298.400 N.�AC <br /> �,-�,�- jz /�9J:�',� <br /> OwnsrlAuthodzotl Apenl SIpn�Wro Date (Rewsed 17/d0f0) <br /> 1 �Z <br />