Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/dEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 1 a �-17 ` � Z <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 <br /> SITEADDRESS: PROPERTYTAXp P�iR�� � _ O <br /> 2 <br /> . ..cu�r � ���� <br /> LEGAL lor new wnslruction: Snotl PlaVsubdivision _Lot No._ (attach copy ol long legal Cescnption) <br /> OWNER � t,1 ,' Phone�E�mail <br /> Adtlress ��� „Z v P� wC City/Slate/Zip <br /> APPLICANT: Ovmer Owner'sngem ,.,,�Contracior ComradorsAgent _7enaN�m�sicmra..kix�ai�o�.emnommew�rromwnmm..c�.1 <br /> CONTRACTOR � �c ' � —�W��4 �' L 8 I Lic.# COE Bus.LIc.# <br /> Address ��?V / ��� �4.1' N� 1 J V4U ���� P�oneJEmaiIL - $°� :�=Z �' U <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E�mail <br /> BUILDING PERMIT APPLICATION CON7tuCT PRICE oF WORK <br /> Existing Use of Building � HFAT SOURCE: <br /> Proposed Use of Building Gas Eiecvic_ Oiner _ <br /> Building type: _Sin91e Family ,_Duplex_Townhouse _Multi-Family _Commercial <br /> T pe of pro'ecl: New Addition Remodel Repair T.I. Si n S rinkler Demolilion Chan e of Use <br /> DESCRIPTION OF WORK(addaiona�space prov�oed on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJecU _New_Addn �,Alleretion_Repalr TypeofProJeck _New_Addn _Alterotlon_Repair <br /> Show Number(p)ol0x(ures Show Number(0)o//iatures <br /> AIC–air handling units Toilet <br /> Forced air syslems Balhlub <br /> Gas pipin Lavato (wash basin) <br /> � Water heater Shower <br /> Gas lireplace Kitchen sink 8 disposa� <br />, Gas ran e �ishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Waler healer <br /> Exhaust fan Sink(service/badmopletc.) <br /> Heat pump 6ackflow V�evenler <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeralion � Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPYtESS10N SYSTEM other: <br /> Number of Heads Olher: <br /> I lmreby cerlAy Ihol l have read onE e+emmed Ihis npPllwtion ona knmv I�o eoma to Oa Irua an0[ortecl.M provisions ollavn anC ortlinencea BovemmB�hu rype af�roA w�00a comptied <br /> wAh whcihet 6petifad herein ot naL Thn Branlinp ol a pertnit doea not presuma lo B�o nut�otlry to NoWle o�wncel Na p�oNsbn ol ony oNer slale or local law regu!a1bB consiruction <br /> Thal I om aut�otlzed 6y�ha avne�oiNle Droperry la pedorm iho work lorw�kh apP�o�a^��matle xnC I wmpN wih Na Slate CoNratlon Low 1827 RCW entl 298200A WAC. <br /> � � ��� <br /> Owner/f'aj!or� A� hl SlgnaCurc Daie (Revisetl N2012) <br /> L � / � <br />