Laserfiche WebLink
( <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—ww�v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM 2��8� I <br /> SITEADDRESS: r�f pO � ^,D� � PROPERiYTAXN F �T� 2 O <br /> � � L <br /> LEGAL for new conslruction: ShoA PlaVsubdivision Lol No._ (attach copy ol lonp legal desuiplion) <br /> OWNER �A ��/� Phone/E•mail 2� 6�3 d�'/J 7 <br /> Adtlress o � e� �,3 CitylStale2ip LV C.�R-cs <br /> CONTRACTOR ��� �d I� �SfT.� L 81 Lic.f� �2 JD G"�' 9 8'I � <br /> Address S Z��j ,V= � � C/2-T I�N�l.J 7�O � PhonelEmail 7�D(�' �OiJ•/) � y <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE•mail <br /> BUILOING PERMIT APPLICATION CONTRACT PRICE OF WORK �o�D <br /> Existing Use ol Building �'s r �">F ,vG ' HEAT SOURCE: <br /> Proposed Use of Building Gas Electnc Other <br /> Building type: ✓Single Family _Duplex Townhouse _Mutti-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repalr_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description ot Work(additionsl space provided on tha 6ack): <br /> R..L •�2oD�= � No rjTRJL��/1.L-S" C bI�/uG-l+S <br /> Have you started working without a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o1 ProJect: _New_Addn _Alteration_Repair Type ot Project: _Naw_Addn _Altention_Repalr <br /> Show Num6er(N)o//7xturea Show Number(N)o!Ilxturea <br /> A!C—air handlin units Toilet <br /> Forced air s siems BathWb <br /> Gas iping Lavato (wash basin) <br /> Water heater Shower <br /> Gas freplace Kitchen sink 6 dis osal <br /> Gas ran e �ishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan - Sink(service/barlmopletc.) <br /> Heal pump Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountein <br /> Refri eration Fioordrain <br /> Woodstove Grease Uap <br /> Ductin Roof drains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> I here6y certify iha�1 have read and exam!ned�his appliw�lon and know Ihe same to be irue and correcl.All provisions of lawa end ordinances goveming <br /> this lype of wark vnll bo complied wilh whether specified herein or not.Tho granling of a permit does nol presume to give authority to violale or cancel <br /> �he provision ol any other state or lowl lew regulaling consWctlon or�he pedortnante of consWction.That I am au�hodzed by Ihe owner ol ihis propeAy I <br /> lo peAomjMe work lor which appliwliqt�-is'�f�tl�e and 1 compiy with the State Conlractors Lav;1827 RCW and 298200 WAC , <br /> / <br /> �� /�. �io. �� � <br /> OwnerlAJtborizedAgentSipnature Oale (Revised7/PO77J I <br /> % <br /> V <br />