Laserfiche WebLink
�ERMIT A FPLICATIO� <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> _0 <br /> SITEADDRE5S: � PROPERttTAXA PERMITf <br /> LEGAL far new conslruc!ion: Short PlaUsubdivision Lol No.� (allach copy of long legal Oescription) <br /> OWNER � elE-mail <br /> Address (� (J City/State/Z'�p <br /> APPLICANT: Owner OwnefsAgen CONractor Contrador'sAgent Tenanll�sipodaa•bne;aimnseMo-anu.ownerioaowon�mvusp.cel <br /> CONTRACTOR State Llc.# Cit Bus.Lic. # <br /> Address PhonelEmail ' <br /> TENANT BUSIN SS NAME CONTACT FOR PERMIT <br /> PhonelE•mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Ezisting Use of Building _ HEAT SOURCE: <br /> Proposed Use of Buitding Gas_ Eleclnc_ Other_ <br /> Building type: _Single Family _Duplez_Townhouse _Multi•Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler Demoli�ion_Change o(Use <br /> DESCRIPTION OF WORK�addi�ional space provided on Ine back): � <br /> / NS�'� �- I �to�Al t� S S I ti' K- I2'�C 12J � N G�3 • <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type oi ProJect: _Naw_Addn _Alteration_Repair Type of Project: _New_Add� _Alteralion_Repair <br /> Show Number(N)of/irtures Show NumDer(N)of fixfures <br /> A/C—air handlin units Toilel <br /> � Forced air s stems Bathtub <br /> � Gas pipin Lavalo (wash basin) <br /> � Waler heater Shower <br /> � Gas fireplace � Kitchen sink&disposal <br /> Gasran e Dishwasher <br /> � Clothes dryer Clolhes washer <br /> Range hood Waler healer <br /> Exhaust fan � Sink(servicelbadmoplelc.) <br /> Heal um Backflow preventer <br /> � Unit heater Urinal <br /> Boiler � Drinking Fountain , <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ducting Roof drains <br /> O�her Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM Other: <br /> Number of Heads ��hef� <br /> 1 nereby cerlily thel I heve reatl eM ezeminetl Ihis eppficaiian end knowlhe same lo Ea Irue and correct.All provisions of laws and ordinencez goveming Ihis lype olwork will be wmpfed <br /> wilh whel�er specifie0 herein a nol.T�e graNing ol a pe�mil eoes not presume logive aut�orily lo vblate or wncel lne provision ol any oNer stale a laal�awregulating wnslmclion <br /> T�al I am aul�u¢eE Ey�he owne�oi t�is pro0arly�o pertorm Ihe xrork�w w�ich applicelion Is mede and I comply wilh Ue State ContraUors lew 18.47 RCW anC Y96200A WAC. <br /> ;� . p 0 i� 08 -D 1�- I �{ . <br /> OwnerlAut o� gentSign ture Date (Revised3?013) <br />