Laserfiche WebLink
� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIRLUMBING/SIGN/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 ACCEPTEO FROM 8 AM TO 4 PM �— '�-���I <br /> SITEAODRESS:�I PROPERTYTNIfN i��tl�1 MDfl JD <br /> ��'� � U <br /> LEGAL br new constmction�. Short PlaUsubdivision Lot No. (altach copy of long le9al tlescnption) <br /> OWNER Phone/E•ma�l <br /> AdEress � Ci�y/5tate�Zip ��, �� <br /> CONTRACTOR � L 8 I Lic.# I ' � J <br /> Adtlress �,J� Phone/[mail - f <br /> TENANT BUSI ESS NAME CONTACT FOR PERMIT pr <br /> Phone/E�mait <br /> \.� �'YIGf`S <br /> BUILDING PERMIT APPLICATION CONritqCT PRICE oF WORK l��d-J� <br /> Exisling Use o(8uilding ��� _ �HEAT SOURCE: <br /> Proposed Use of�wlaing GasL Eiecinc_ Otner_ <br /> Builtling lype�. �Single Family _Ouplez_Townhouse _Mulli-family _Commercial <br /> Type of projecC _New _Addition _Remodel _Repair_T.I._Sign_Sprink!er_Demolition_Change of Use <br /> DesCripli0n of Work(adtlifional sp e p��iQed on Ihe back�: <br /> �e,�lac�e. �us �.r�acA $a- 1� ��►�' o <br /> Havc you started working wilhout a permit� _YES _NO <br /> MECHANICAL PERMIT APPLICATION Pf.UMBING PERMIT APPLICATION <br /> Type of Project: _Nrw_Addn _Alteralion_Repair Type of Projecl: _New_Addn _Alleralion_Repair <br /> Show Nunibcr(#f ollixtures $how Num6er(qJ al�rfures <br /> A/C-air handhng units Tollet <br /> Farced air s slemo Bathtub <br /> Gas piping _ Lavatory(wash basin) <br /> Water healer Shower <br /> Gas fire lace Kilchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clolhes dr er Clothes washer <br /> Range hootl Watcr heatcr <br /> Ezhaust fan Sink(servicclbadmoplctc.) <br /> Heal pum Backllow reventer <br /> Unit healer Urina� <br /> Boiler Unnkin Founlain <br /> Refn eratlon Floor drain <br /> Woodslove Grcase tra <br /> Ducting Rool drains <br /> Othcr Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Numher of Ileads Olher. <br /> I hemby cerldy Ihat I have rea0 ana e.amined tnr,aJO�iration antl know Ine same lo be Irue antl correG.NI pmnsions ol laws and or0inances 9oveminq <br /> thi,lype ol work vnll be wmplied vnih whclher s0eu�letl heicin or not.Thc granUng ol a Oermil dnus not p�esumc lo grve authonly to violale or unccl <br /> the provision ol any olt�er slale or local law regula6nq conslruC6on or Ihe Oedormance of con,lruclion.That I am aulhonzed 6y Ihe ovrtier ol Ih�s propmty <br /> lo peil m e 6�k 1 F�vA�iU�app�rabon is rnade nni I comply wilh Ihe Slale Conlractors Ww 1(��27{2CW and 29G200 WAC <br /> � � <br /> OwnenAulhoriretlAg tSignaturc Oale (Revaed7J20f1) <br />