Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <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 `-I� �' � � <br /> SITEADDRESS:� � �. PROPERiVTAXp PfRMIJ�M _ <br /> > C� L <br /> LEGAL for ne�v construction: Shoh Plat/subdivision Lot No._ (altach copy ol iong iegal tlescnotion) <br /> OVYNER g � c� /'V P�one/E•ma�l S -6 y7 - 6 <br /> ddress Q ' - ' ' ciry�stateizip �8`� <br /> APPLICANT:_Owner Owner'sAgent Comractor _Contractoi'sAgent TenaMtm�:�o�ow..kr��o��om�mrtomm.a�«maoMon���muw«� <br /> CONTRACTOR ` G"� C L CO i L&I Lic.# C.(�,S _ 'rj GOE Bus.Lic.# <br /> Addiess C( �i ff �L ��/'[,�= . , �Y� Phone/Email �y �C7 � y <br /> TENANT BUSIN S NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � �C'� � <br /> Existing Use of Building (��S f E•'LCf H7EAT SOURCE: <br /> Proposed Use of Building �F;�r•� L l`eS ��Qd.<-C � Gas Eiednc Other <br /> Buildingtype: �SingleFamily _Duplex_Townhouse _Mulli-Family _Commercial <br /> T pe of pro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESC RIPTION OF WORK�add�tionai space prov�dea on tne bace): <br /> i� <br /> :j ti��,�« �l ��� d�u�Gt�'o� � w. <br /> MECHANICAL PE RMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJecl: _New_Adtln _Alteration_Repalr Typu ol ProJect: _New_Addn _Allerotion_Repair <br /> Show Number(N)ol IiaYu:cv Show Number(N)01/lxtu�es <br /> NC-ai� handling units Toiiet <br /> � Forced uir systems Bathtub <br /> Gas pipir� Lavato (wash basin) <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/barlmoplelc.) <br /> Heal pump � Backflow preventer <br /> Unil h=ater Urinal <br /> Boiler Drinkin Fountain <br /> Retrigeralion Floor drain <br /> Woodstove Grease tra <br /> � Ductin Roofdrains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM � Other: <br /> Number of Heads Other; <br /> I�ere�y cenM Nal I hova read md e.amineU t�is apP�Ka�q�and know No soma ta Co Iruu eW cortecl.AA pmvislom ol Wvn nn0 orOnancee gavemNp I�u type olwork vn9 ba comp6etl <br /> wnh wiceltier speuf�ed Aerein or not T�o pmntin0 0l n pem�il aoes nol presumo lo grco nul�onry lo violalo orcancel Na pmvision ol eny olher slsle or Ixal law repulatlnp coneWclion <br /> T�ol I am nuNonzeE by tho owne�oI1N�pmpetly lo petlmm Iho wod IorwOk�applicutbn if mnCe anE I compy N1h I�o Sla�o CanUaclon Law 18.27 RCW and 29fi200A WAC. <br /> /i � / <br /> C ,��j'��/����� � <br /> Owncr/AulhndzedAgcntSlgnaWrc Dale fRevisetl6/20f2) � <br /> n <br /> '' w <br />