Laserfiche WebLink
PERMIT APPLlf:ATION <br /> BUILDING/MECHANICAL/PLUMBING/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 /> SITE ADDRESS: �O� PROPEHiY TA%G �RMIT It _ _`� <br /> u�� <br /> LEGAL lor new con5iruction: ShoA Plal/subdivision Lot No._ (atlach copY ol lang Iegal Cescnplion) <br /> � OWNER v ��L� � �� PhonelE-mail �;ZS -Sla - $06 <br /> '�I Adtlress Q�jv �1- �� , — — GIYIS1ale/2iP � <br /> � APPLICANT:�Owner OwnersAgent Contraaor Conlraaor'sAgenl TenaN�muaemn�ooicnno�w�.semnommoo.�e�maowonmmo:v��sl <br /> CONTRACTOR ►�C�+ State Lic.# Crt Bus. Lic. # <br /> �ddress Phonel[mail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone�E-ma�l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Builtling_ HEAT SOURCE: <br /> Proposed Use of Building_ Gas_ Eiecmc ✓ oiner__ <br /> Bwlding type: =/Singte Family _Duplez_Townhouse _Multi-Family _Commercizl <br /> Type of projecP __ New ._Addition _Remodel _Repair T.I. _Sign_Sprinkler Oemolition�Change oi Use <br /> : <br /> DESCRIPTION OF WORK(add�nonai space proNded on rhe backl: <br /> Ol.t� p� i ►�C��I�C� � �t7 �i o `�-ct-fi-Ci-t�i� O=� �-t Eh?� <br /> �rtZ'T0�-f jl�C�'fV '�t��l �i �q � l �-�t� � ��wner S0. 5 �t �ac� � <br /> 0 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICA ION <br /> Typo ol Project: _Now_Addn _Atterollon_Repalr Typo ot ProJoct: _New_Addn _Altorotlon_Repair <br /> Show Number(R1 0!/ixtures Show NumDer(tl)oflirtums <br /> NC–air handling units � Toilet <br /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> � Water healcr Sho�rer <br /> Gas fieplace Kitchen sink 3 d�sposal <br /> � Gas ran9e Dishwasher <br /> Clothes dryer I Clothes washar <br /> Ran e hood Water heater <br /> Exhausl lan Sink(servicelbadmop/etc) <br /> Hea�pump I Dackllow D�eventer <br /> Unit healcr I Unnal <br /> � Boder I Dnnk�ng Foun�ain <br /> I Refrigeralion Floor drain <br /> Woodslove Grease trap <br /> Ductmg Root drains <br /> Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYS�EM � Other <br /> Number of Heads � Other: <br /> I AewUy cenily t�at I�ave icad anE evammea I��s app�:ca:�on anC knvw 1ne sama lo De Irve anE caircd.All pmvisions ol laxs nnG orCmances goveming I�is lype o1woM�n7 Ee CamDlied <br /> �nnh w�et�er specA�cG I:e�em or nat TTu qr�nlmg al a pertnrt Ooes nal Dresume lo grro auIDorrcy lo v�ola!e or ranccl l�e p:oriswn cl anr at�er state or lowl Ww mgulatng wnslruclion <br /> Tnat 1 nm aul�o�¢eE Oy Ne owner ol In�s D�opeOy lo Detlorm t�c work for wn¢h uppi�wtion is maaa enE I compy wnh no Slale Co�baeon Ww 18 27 RC W nnd 3?0100A.V�C <br /> �n'�p� s�� � u/3o��3 <br /> OwnerlAuthorized Ag�nt Slgnaturo Date (Rev�sed32013) <br />