Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANIrAL/PLUMBINGISIGN/SPRINKLER/DEMO�ITION <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 -J'—I� 'I Z� <br /> SJ�'77'�1,{nDDRESS: (� � � � PR!O1PERTY TAX N q � PERMIT• _ <br /> l O'�/ E�W0.�.-�cLS -RVL� ol ���/ JJ� <br /> LEGAL for new construclion: Shotl PlaUsubdivision Lol No._ (altach copy ol long legal descriplion) <br /> CYl[�}q� w.orC <br /> OWNER �G yy� �Z PhonelE-mail ��e g�q J � �•� <br /> Address �� �.S CilylSlale/"Lip �fC�C�1... � ft' �Ua-b� <br /> CONTRACTOR O L 81 Lic.# <br /> Phone/Email <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Ph�ne/E-mail Eri� Z�� � ��O' � `�� <br /> BUILDING PERMIT APPLICATION coNTRACT PRICE oF WORK 346Ob OC7 <br /> Existing Use of Building '� 2Stc�C- HEAT SOURCE: <br /> Proposed Use of Building 5�+�-�--- Gas_ Electric _ _Other_ <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition ✓Remodel _Repair_T.I._Sign_Sprinkier_Demolilion_Change of Use <br /> •+-1��\\ <br /> DeScriptionofWork(addifionalspacoprovidedonfheback): �t�MO�� �ha w�dQF� o� p � ���-ed bASew�2.��-, <br /> v,rauks ��h<<,.�•, vltw haa.�+ SY��. M1ew e�ic4viC SE�vicC , h.l�..� d��,..x+�t� +tC�..> in��Iwtjo,•1 <br /> hsw SevvicR Pane\. }G+�pn� t�nlu�acl�,.��^dow opu..t.-��S � �i�.roow. vrw.od� l� pnou< wA�% <br /> 1�u�{,✓� <br /> Have you slarted working without a permit7 _YES _NO <br /> MECHANICAL PERM17 APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJecl: _New_Addn �Alteralion_Repafr Typu ol ProJoct: _New_Addn �Altoration_Ropalr <br /> Show Numbcr(fl)o!/ixfures Show Namber(N)o/fixfures <br /> � �( Toilel <br /> 5 X Bathtub <br /> � Gas piping X Lavetory(wash basin) <br /> Water heater I Shower <br /> Gas fireplace Kilchen sink 8 disposal <br /> � Gas rangc Dishwasher <br /> � Clothes dryer Clothes washer <br /> Range hood � �'� <br /> x Exhaust fan Sink(service/bar/mop/etc.) <br /> X I Heal pump � Backflow prevenler <br /> Unil healer Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> - Woodstove � Grease trap <br /> — x Ducting � Roofdrains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number ef Heads I Other: <br /> I hemby cedify lhat I have read and examined Ihis applicalion and kno�v Ihe same lo be true and correcL All provisions of laws and ordinances governing <br /> this type of work�vill be complied with whe�her speci�ed herein or not.Tho prenling of a pefmil does nol prosume to give aulhority to violate or cancel <br /> Ihe provision ol any other stale or local law regulating construclion or�he pertormance of construction.Thal I am authorized by the owner of this pmpedy <br /> to perlorm lhe work for which application is made and I comply with Ihe SIaIe Conlractore Law 7827 RCW and 296200 WAC <br /> �itit- �-��°f�`'�Z l <br /> nadAulhorizod Agont Si�naturo Date (Revised 2R071) L <br />