Laserfiche WebLink
� � �ERMIT APPLICATIG� �� <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETI'PERMIT SERVICES � —Q`� — U <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—ww�v.everettwa.org <br /> MPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> SITE ADDRESS: ►ROPENTY TIUf 11 PERM /D O <br /> Ilo�lo �AuJEF1E�OWhY Ev�ae�� Wn ;.�� � <br /> LEGAL lor new wnstrudion: Short PlaVsubCivision C+_S3�eS_�,y� ��G�y�_Lo�No._�� (anach copy ol lonp lepal description) <br /> OWNER ,�< �;ac,S NW 11.0 Phone/E-ma11 �425� 33� 'S6° G <br /> Address r J 6�X 14'�Z`I City/Slele/Zip (��w �.�-EEK W,4 yL��c <br /> CONTRACTOR C.,o;t =rt5-t. � ��McS N�J LI.0 L61Lic.# C�-fZNtHN94� GA <br /> C41S 33.-S:S.Z <br /> Address PU Quy �`�`{Zy �11u �ELk �rl�F 9.J�d2 Phone/Email .i�n�v��N„StiNEM.�MES.u1 <br /> TENANTBUSINESSNAME CONTACTFORPERMIT �„�An- �MPu�R <br /> PhoneiE-mail ��'IZS�33�L-5`p55I,����?c,.Rric'S�n.�r_H,.;r�S.U 5 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Ezisting Use of Building_,______ __ HEAT SOURCE: <br /> Proposed Use of Building_____ Gas_X_ Eledric____ Other____ <br /> Building type: X Single Family _Duplez_Townhouse __Multi-Family ,Commercial <br /> Type of project: �New ,Addition _Remodel ,Repair_T.I._Sign_Sprinkler__Demolition_Change of Use <br /> Description of 1M1'ork(addilional space provlded on Ihe back�: <br /> b�s� � -� 4it �Pu+� ►�55 A� <br /> Have you started working wtthout a permit7 _YES _�NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pro�acl: )LNew_Addn __ Altenllon__ Rep�ir Type ot ProJact: �New__Addn _All�nllon_R�pdr <br /> Show Number K�or n�r�ro� Show Numb�r R of flxtunt <br /> PJC—air handlin units 3 Toilel <br /> Forced air s stems 2 Bathtub <br /> Gas i in lavato wash basin <br /> W aler heater Shower <br /> Gas fire lace 1 Kitchen sink 8 dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er 1 Cbthes washer <br /> Ran e hood �K Waler heater <br /> y Ezhaust fan Sink servicelbar/mo letc. <br /> Heat um Backflow eventer <br /> Unit heater Urinal <br /> Boil,• Drinkin Fountain <br /> ReL, eration Floor drein - <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other------------ Mediwl Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> � Number of Heads Other: <br /> I hereby certity Ihat I have read and examined this applicalion and know�he same to be true and corted.All provieions of laws and ordinances goveming <br /> this type ol work will be complied wilh vfiether specified herein or nol.The granling ot a pertni�dces not presume to yive au�hority to violale or cance� <br /> Ihe provision of any olhet slate or local law reguiating construction or Ihe peAortnance ol construction.That I am authorized by Ihe owner ol this property � <br /> lo peAorm Ihe wnrk lor which applica�ion is made and 1 comply wi�h�he Stale Conlraclon Law 18.27 RCW end 296.200 WAC � � <br /> �'TR� �„,.�� s j�s i�� <br /> OwnerlAuthori:ed Apent Sipnature Date (Revised LPOf 1) <br />