Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLER/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 /> Z�I � APPL�CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� .��� <br /> 'a � cor u��-�� <br /> LEGAL for new wnstniction: Short PlaUsubdivision Lot No.__ (atlech copy of long legal descriplion) <br /> OWNER q + � �1t�C Phone�E-m�fi � 4..C� � �G 77� <br /> Address ��ry.� (C�l�� ��rrG � %v�� CIIylState/Zip <br /> CONTRACTOR;�i.�N � .D � L 81 Lic.p SGUI�G+ IP <br /> naaress3l¢c� !39'"' �$ui' '�� 8ellFv W'� y�Lt>� Fhone/Email !S �j�� / �/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ����(b� �21 PhonelEmail �LG 77 ZS � �O L� <br /> BUILDING PERMIT APPLICATION coNTRnCT Pa10E oF WORK ��j <br /> Existing Use ot Building �^••� HEAT SOURCE: <br /> Proposed Use ot Building �� _ Gas Elecldc Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family 7�Commercial <br /> Type oi project: _New _Add�tlon �Remodel _Repalr_T.I._Sign_Sprinkler_Demolitlon_Changa of Use <br /> Description oi Work(additional speca provided on the back): <br /> � — �vu� � �'1'''� <br /> Fiave you sWrted working without a pertnit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJact: _New_Addn _Alteration_Repair Type oi Projaet: _New_Addn _Alteration_Rap�lr <br /> Show Number(NJ o//Lrtures Show Number(N)o/Rxtures <br /> A/C—air handlin units 7oilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavalo wash basin <br /> Waler heater Shower , <br /> Gas fire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> C�othes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust(an Sink servicelbarlmo letc.) I <br /> Heat um Backflow reventer ' <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrein <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM _ Other <br /> Number ol Heads <br /> I hereby certity that I have read and examined Ihis application and know iho samo to be Irue and wrted.All provisions of lews and ordinances goveming <br /> this lype of work will be complied with:vhelher spedfied herein or not.The granting of a permit does not presume lo give authority lo violate or cancel <br /> Ihe provisfon of any other slate or local law reguleting conslruction or the perfofmance af constNclion.Thal I am authorized by the owner ot lhis property <br /> lo perfa o w h application Is made a�d 1 compty wilh Ihe Slale Conlraclors Law 18.27 RCW and 296.200 WAC <br /> /' <br /> �_ � . ��ld��� <br /> . <br /> OwnarlAuthorized Agent Signature Dale (Revised 77lt070) I <br /> /� <br />