Laserfiche WebLink
PERMIT APPLICATION <br />BUILDING/MECHANICAL(PLUMBING/SIGN/SPRINKLER/CEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />_ r nneoren eonM A AM Tr] d PM <br />V...—... <br />_. <br />PROPERTYTAXN <br />PERMITM <br />SITE Ap�RESSj•� ��/ <br />_ <br />LEGAL for new construction: Short Plat/sub ision Lot No._ (attach copy of long legal description) <br />OWNER <br />Phone/E-mail <br />Address <br />City/Stateop <br />APPLICANT: —Owner _Owner's Agent _Contractor —Contractor's Agent _Tenantrm,stww�aknermwescerrmmtro oxrerb oo wear oma spent <br />�✓!:G vG L 8 I Lic. #.J�% ° � 6F '% COE Bus. Lic. # <br />CONTRACTOR �./% / J <br />PhonelEmail l i ✓ /7 <br />Address <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />1m17)OMAllZe <br />) ,, <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK —+1C <br />7; ll�� <br />HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building ell (/ Gas_ Electric_ Other_ <br />Building type: Single Family _ Duplex —Townhouse _ Multi -Family _ Commercial <br />_ <br />Type of project: _New _ Addition Remodel _ Repair _ T.I. _ Sign _Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back)' <br />��o,��'rfi,�.e �-Siys`%(�, 5��vy/e �'�S�y/1/ �"c x1d�C�/�,�Itl�✓��, <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Alteration_Repalr <br />Type of Project: _New_Addn __Alteration __Repair <br />_-New,_Addn <br />Show Number (#) of Postures <br />Show Number (#) of fixtures <br />I AIC— airhandlingunits <br />Toilet <br />I Forced air systems <br />Bathtub <br />Lavatory (•Nash basin) <br />Gas piping <br />Shower <br />Water heater <br />I Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes dryer <br />I Clothes washer <br />I Range hood <br />Water heater <br />Sink. (service/barlmopletc.) <br />I Exhaust fan <br />I Backflow, prevenler <br />Heat pump <br />I Urinal <br />Unit heater <br />I Boiler <br />I Drinking Fountain <br />Refrigeration <br />Floordrain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains ^ <br />Othnr <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby comfy that I have read and examined this application and know the same to be two and correct. AN provisions of lawn and ordinances govemng the type of wmk will be complied <br />vkh whether specired eh or not. 7ho granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law mgulatho construction <br />Thatlamaulh*zedt <br />of this pmpeM to perform the work for which application is made and l comply with me State Contractors Law 1e.27 RCW and 29621x7A WAC. <br />l <br />OWnerIA nature <br />Date (Revised 62012) <br />