Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICALIP'_UMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA�J8201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEAD ESS' �'n / �ti� _ � PROPERiYTAXN PERMITk ^ <br /> -/- �� 1 RL. �� �2 -� U <br /> LEGAL for new wnslruction: Short olaVsubtlivision Lot No._ (atlach wpY ot long legal des-ration) <br /> OWNER ��} � �� I� � �-�--U PhonrJE-mail .d-'- _�-ZIG � .1 V L�P� <br /> Atltlress �_ �)� �� ��-�' -�r City/StatMZip C �z � ��1fT� �� J��' � <br /> APPUCANT:�Owner OwnefsAgenl Coniratlor ContractofsA9ent _Tenantlm�.ipmdaaatmrolrn�semeonnew*��oeawon.�nnew+�) <br /> CONTRACTOR n' - L&I Lit.# COE Bus.Lic.# <br /> Adtlress � �-� � � ��,fL-VivL Phone/Email <br /> TENANT BUSINESS NAME ` CONTACT FOR PERMIT <br /> Phone/E�mail <br /> BUILDING PERMIT APPLICATION Con7RACT PRICE oF WORK -3 �- C N�"— <br /> Existing Use ol Building '-•(��� •��� ��� �" � �i��` — HEAT SOURCE: <br /> Proposed Use ot Building � Gas Eledric O�her <br /> Building type: _Single Family ,_,Duplex_Townhouse _Multi•Family _Commercial <br /> T pe of project: New _Addition Remodel Repair T.I. Sign Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(adoinona�space provided on tne back): <br /> � ' �[(C� t� �l> -��C�"� �'c�� �lli -� l.lrr�c. �l <br /> 7` t� _) <br /> MECHANICAL PERMIT APPLICATION PLUMB�NG PERMIT APPLICATION <br /> TypeoiProJecL• _New_Adtln _Alteration_Repalr TypaofProJect: _New_Addn _Alteratlon_Repalr <br /> Show Num6er(N)olOxfures Show Number(q ol llxfines <br /> A/C-air handling uni�s Tailet <br /> Forced air s slems Bathtub <br /> Gas pip:.ig Lavato pvash basin) <br /> Water heater Shawer <br /> Gas fireplace Kitchen sink 8 disposal <br />` Gas range Dishwasher <br /> Clothes d er Clothes washer <br /> Renge hood Water healer <br /> Exhaust fan Sink(servicelbar/mop/elc.) <br /> Heal pump Backflow prevenler <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeralion Floor drain , <br /> Woodslove Grease trap �� <br /> j Ductin Roof drains � <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Olher: <br /> I hem0y certM Nol I�ave rcad nn0 maminetl lhis applicnlbn nntl know t�e mme to be Uuo on�corted.M pmvisiam ol lawa enC ottluiancea Bovemh9�hia type ol woM vnA ba complied <br /> wn�wTelher sp^�.ilreE hemin or nol.l�^7��nOn7 0l a pertnil tloea naI prcsumo to piva eut�onry lo WoL:ta o�cancel No pmNsion ol any olher slale or local L�w repul�linB�ons W ction <br /> That I am auNatlzeC Oy Iha rnvneroll�la pmperry lo padartn Ihe work lorw�kh oppf¢ntion is mnEe entl I compy w1�Iho Slele Coniraclon Lew 1827 ftCW end 298100A WAC. <br /> \ <br /> �L N� � � � ' ;�.. ���� �� � <br /> OwnerlA rthorized Agent Signaturc Date (Revised(J2011) <br />