Laserfiche WebLink
. . • � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TA%p j� ' I <br /> /d0�/ G✓E..�G�Q.�c.N � L�I�OI `7 <br /> LEGAL for new wnsiruclion: Short PlaUsubtlivision Lot No._ (attach copy ol lonp legai descriptlon) <br /> OWNER SOVTs/ �o�lJT 1�L�}J� L(.L PnonelE•mall <br /> aaress yo(� �c.1.iNGSew/ .�.� c�ryBtate2ip j7Mc.iFic. W.� 0�� <br /> CONTRACTOR :-O$ L&IUc.# <br /> ddress 77D S W t��/�ST B �/t77I! G/ D/L73i �'nonelEmail �� <br /> TENANTBUSINESSNAME. CONTACTFO?R�A��S �,8�2 "I���✓� <br /> ���a� �� PhanelE-mall�� /S • G�-OA$ Ap LO � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Ezisting Use of Building HEAT SOURCE: <br /> Proposed Use of Bullding �TA�L Gas Eieclric Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel __Repalr_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> DeScripti0fl ot WO�k(atldiliona!space provided on the 6ack): ��.T✓�C�S <br /> ,usT►u.Ariorl oF' sr�svv„c arlc�Fowrl¢ al� sE+�cc.T � <br /> ShelveS� �acks—i�te� a�' <br /> Have you sWrted working without a permlt7 _YES X NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATiON <br /> Type o1 ProJect: _New_Addn _Alteratlon_Repalr Type o1 ProJect: _New_Addn _Altarotlon_Repalr <br /> Show Number(M)ol flxfures Show Num6cr(N)oI Cxtures <br /> A/C—air handling unils Toilet <br /> Forced air s slems Batntub <br /> Gas i in Lavato (wash basin <br /> � Water healer � Shower <br /> I Gas f replace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Cblhes d er Clothes H•asher � <br /> Ran e hood Water heater <br /> Exhaust(an Sink(servicelbar/mo /etc. <br /> Heat ump Backilow reventer <br /> Unit heater Urinai <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain � <br /> Woodstove Grease tra <br /> � Ductin Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other: <br /> Number af Heads I Other: <br /> I hereby cerlity thal I have reatl and examineG lhis applicalion antl kno.v ihe same lo be true and wrrecL All provisions of lews antl ordinances goveming <br /> IOis type of work will be complied wilh whether speciGed herein or not.The grantlng ol e permil dces not presume to give aut�ority lo violate or cancel <br /> the provision of any othar or local law r ating wnstruclion or the peAortnance of conslruction.That I em authorized by the owner of this property <br /> ta perlorm ihe vrork lo ich c 'o matle an mply wit�the State Conlractors Lew 18.27 RCW and 286.200 WAC - <br /> � �' ZN . 2U' /L <br /> Ownerl I ature Date (Revised 7/2011) <br /> /2 <br />