Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/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 /> SITEADDRESS: PROPERTYTAXp PE T <br /> � � �-��� ; � �Aa '� /�,�� " i,�, , <br /> LEGAL lor new conslruction: Short PlaVsubdivislon Lot No._ (attach copy of long legal descrip�ian) <br /> OWNER �rAn I'� �7-K N a ��� PhonME�mail `F Z � 3 4 S z u&� <br /> Address ''+'R 3� �r�.P��'��• 1^� N� CilylSlale/Zip � .. <!'c t T Gw A �]� 1 i z <br /> CONTRACTOR c7 v n t r L 8 I Lic.# <br /> Address Z' A Phone/Email <br /> TENANT BUSINESS NAME CO�ITACT FOR PERMIT <br /> Phane/C--mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eleclnc_ O:tier_ <br /> Building lype: _Single Family _Duplex_Townhouse _Multi•Family _Commercial <br /> Typeotproject: _New _Addition _Remodel G Repair_T.I._Sign_Sprinkler_Demolition_Change ofUse <br /> Description o(Work(additional space provided on(he back): , <br /> �, <br /> =� �f�� ,�..��,��, r� ,��1' -���' ^� ���.'� � e. �f����,�.'� <br /> Have you started working wfthout a permit7 _YES _NO <br /> MECHANICAi. PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol ProJecl: _Now_Addn _Alleration_Ropair Typo 01 ProjucL• _Now_Addn _Allnratlon_Repair <br /> Show Num6er(N)ol/ixtures Show Number(pJ oI/ixfures <br /> � A/C-airhandlingunits ✓ Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Y Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Cl�thes dryer Clothes washer <br /> Range hood W ter heater <br /> Exhaust fan � � Sin service/badmop/etcJ <br /> Heat pump � BackFlow preventer <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeretion Floor drain <br /> Woodstove Grease trap <br /> IOuctin � Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION �YSTEM Other: <br /> � Number of Heads � Olher: <br /> I hereby certify Ihat I havo rer�d and examined Ihis application and kno�v Iho san�e to bo irua and correct.All provisions ol iavrs and ordinances governing <br /> lhis rype of work will be comp'ied with whether specified herein or oot.Tho granling ol a permit does nol presumo ta give authorily lo violato or cancel <br /> Ihe provision of ony olher sta'.e or local law regulating construclion or Ihe peAom�anco of conslruclion.That I am authorized 6y Ihe owner ol lhis propeAy <br /> lo peAorm the�vork lor which application is mado and I comply with Ihe Slato CoNractors Law 18.27 RCW and 296200 WAC <br /> ,. ;., ,� --� .�,��' � � !L <br /> Owner/Authodzed Agont Si�naturo Dale (Revised7l1J17J <br />