Laserfiche WebLink
PERMIT APPLICATIOIv <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857-wNnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO a PM <br /> SITE ADDRESS: PROPER7Y TA%# PERMIT# <br /> r C J-r !�c^ -� �..,< O�)`-/ � 1 (� - c^C� (Y11 - Uc r <br /> LEGAL for new consWction: Shoh Plat/subdrvision Lot No._ (atfach wpy oF long legal descnption) <br /> OWNER �7�P��'l � �°^-A-'-�' Phon=lE-mail �f�--� ?j '7 7��`-� <br /> Aatlress / C,�`7 i`�� � Gty/Stai=lZiP �Lf-�t+' W JQ �O 3d� <br /> CONTRACTOR (����� ���4� l+..- 1'1 r.L�Y L 8 1 LiC.K �-/ f^ - 3��' �'�y <br /> Address �'�O �.- n:w .�t' Phone�Email .�j� ">��'/ 3��� <br /> TENANT BUSINESS NAME COM�CT FOR PERMIT <br /> �L,a.�; :'� <br /> PhonelE-mail � - yy 73enio C�a.�x%.t `J c, ,S j"ec-'�' ���' <br /> BUILDINGPERMITAPPLICATIfi�N CON7RnCTPRICEOFWORK "-l0� 3"" c' ��t <br /> Ezisting Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas K Electnc_ Olher_ <br /> Buildin9type: k SingleFamily __Duplex_Townhouse _MuP�i-Family _Commercial <br /> Type of projecC `� �lew _Addilion _Remodel _Repair_T.L_Sign_Spnnkler_Demolition_Change of Use <br /> Desc�iplion o(Work(additional space provided on fhe back): /1 <br /> r2.t�, t��. � y-�.�,. rd �J �a, <br /> {-�ch10t_ l;.i , �.�.. V�.' l.li �'�.., �(y.�.-.. t' <br /> � �� -; �o.;. ��v ¢'�: .,.<<- �,` <br /> Have yo started working wilhout a permil? _YES t'NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProject: RNew_Addn _Altoration_Repair TypuofProjecl: _New_Atldn _Alteration_Repair <br /> Show Number f#)o!Iixtures Show Number'p)ol liztures <br /> fVC-air handling uni�s I Toilet <br /> Forced air systems Bathtub <br /> Gas pipin Lavatory(wash basin) <br /> VJater heater � Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas ran e � Dishwasher <br /> Clothes dryer � Clothes washer <br />,-� Ran e hood Water healer <br /> Exhausl fan Sink(servicelbarlmopletc.) <br /> Heat pump Backflow preventer <br /> I Unil hea�er Urinal <br /> Boiler Drinking Founlain <br /> Refriqeration Floor drain <br /> Woodslove Grease lrap <br /> � � Ductin Roof drains <br /> � Olher � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> � NumberofHeads Other: <br /> i r� reby certdy thal I have read and examined�his appliwtion and know ihe same!o be Irue and correct NI pmvisions of laws and ortlinances goveming <br /> �.�. type of H�ork vnll be complied vnth whether spenfiad herein or not.The granting of a permit does not presume to give authoriry to violale or canrel <br /> , -;;iovision of any other state or local law regulanng conswction or Ihe pedormance of conslmction.That I am aulhorized by the ovmer of this pmpeny <br /> .. ;zrform Ihe v.o�k(or which application is made and I comply�tilh lhe Slate Contractors Law 1827 RCW and 29G240 WAC <br /> �. ` 1 `Ll Lt;�;t.. irC.��-t�.�.� ! D � / � �/o^j- <br /> / <br /> Owner/Aulhorizetl Agent Si9nature Date (Revised 22011) <br />