Laserfiche WebLink
PERMIT APPLICATION <br />BUILD[ NG/MECHANICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 9B201 - 425-257-B810 — FAX 425-257-8857 — vNm.everelhvaj.org <br />rn ATrf1\Ie ARE ACCEPTED FROM R AM T04 PM / 0— Q(51-l(_% <br />SITE ADDRESS: PROPERTY TAX h RMIT fl <br />Bcr- <br />1 O2. sr— C r...�,�Lx. wy+` <br />LEGAL for no`wconstmclion: Short PloVsubdivishn Lot No.— (attach copy of long legal description) <br />r,,l <br />OWNER J`5-F'rD FA,�i'1 �V5/-r2�� t-�At-' Ll <br />Phone/E-mail I�� (:�2.3 O`r <br />Address V �J ry �k•o r�r••s -FP• <br />clylslatazip iZV k,�% L C �- 26 / 2.- <br />CONTRACTOR T-_ <br />L & I Lic. # <br />Address PhonalEmail <br />TE�! NT BUSINESS NAME <br />CONTACT FOR PERIAIT <br />L z l <br />/�v <br />Phone/E•mall <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRIM- OF WORK `/Ud�Ooo <br />Existing Use of Building �'C'k� �- HEAT SOURCE: <br />Proposed Uso of Bullring R +-�•� "� __ _ Gas_ Electric_ Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family „G 6ommercial <br />_ <br />Type of project: _ New _ Addition _ Remodel _ Repair _ZT.I. _ Sign _Sprinkler _C`emoljtion_Change of Use <br />DescriptionofWork (additionalspaceprovided on the back) : <br />Have you started working without a permit? _,YES —L-NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project:_New_Addn mterallon_Ropalr <br />Typo of project: _Now _•Addn _:�AIterallon_Ropalr <br />Show Number (a) of Mures <br />Show Number (a) of fixtures <br />No- air handling units <br />I <br />I Toilat <br />Forced airs stems <br />Bplhlub <br />Gas plionij <br />Lavatory (wash basin <br />Water heater <br />I Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas mnpe <br />I Dishwasher <br />Clothes dryer <br />I Clothes washer <br />Range hood <br />r <br />I Water healer <br />Exhaust fan <br />Sink (servicefbar/mopletc.) <br />Heat pump <br />Backilow <br />proventer <br />Unit heater <br />I Urinal <br />Boller <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodslove <br />I Grease Iran <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other. <br />I i � <br />I Number of Heads <br />I Other: <br />�TF�FASY <br />r_ n� <br />I hereby certify that I have road and examined this application and know the same to be two and correct. All provisions of Imes and ordinances governing <br />this type of work will be complied vChwhelher specified heroin or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any otherstate prioRl law regulating construction or the performance of construction. That I am aufharized by the owner of this property <br />to 0 1 the work for which a piicali s coda and I comply vnlh the State Contractors Law 18.27 RCW and 296.200 WAG <br />/S / Z. <br />Ownorl ul orized Agent Signature /Dale (Revlsetl 2r2a11) I/Z— <br />