Laserfiche WebLink
( <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEIV JLITION <br /> CITY OF EVERETT PERMIT SERVICES /o a b-1 ( /�J <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.orLg_..///Q /3/� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM h. 6 <br /> SITEADDRESS: < , � //l � „ ,/ '.�/ _ ROPERTY7AXN RMI7f <br /> ( , �u . r � //D - 6G�'/ <br /> . ._.� <br /> LEGAL lor new consltuclion: Short PlaVsubtlivision Lot No._ (altach copy af long lega�descnption) <br /> OWNER /'� . � PhonelE-maii �l� _ l — 7 <br /> Address � ' �/'� Q Qv� � 0 CitylSta�e/Zip L <br /> CONTRACTOR V %� ��LS �� L 8 I Lic.# <br /> Adtlress `' PhonelEmail <br /> TENANT BUSINES NAME CONTACT FOR PERMIT <br /> V n� '�� . , ' � , PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Buitding Gas� Eleclric_ Olher <br /> Building type: ,,S/ingle Family �Duplex_Townhouse _Multi-Family _Commercial <br /> Type o(projecl: �]New _Addition _Remodel _RepairlT.I._Sign_Sprinkler_Demolition_Change of Use <br /> Descriplion of Work(addifional space provided on fhe back): <br /> Have you started working wilhout a permft? _YES �O <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn _Alterallon_Repair Type o(ProJeet: _New_Addn _Alteratlon_Repair <br /> Show Number(MJ o/17xfures Show Number(NJ o/flxtures <br /> AIC—air handlin unils Toilet <br /> Forced air s stems Bathtub <br /> Gas ipin Lavato (wash basin) <br /> Waler heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> � Gas ran e Dishwasher <br /> Cbthes d er Clothes washer <br /> Ran9e hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit healer Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodslove Grease trap <br /> Ducting Roo(drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I heretry certify Ihal I have read and ezainined this application and know Ihe same la 6e lrue and corted.All provisions of laws and ordinances goveming <br /> this lype of work will be complied wilh whether specifed herein or not.The gran�ing of a permit does no�presume to giva authorily to violate ot cancel <br /> Ihe provision ol any o�her stale or local law regulaling conslruction or ihe perlormance ot construclion.That I am aulhorized by Ihe owner ol this property <br /> �ye�he,work for which applica�ion i:inade and I comply wilh Ihe State Conlrac�ors Lew 18.27 RCW and 296.200 WAC <br /> /1 ^ <br /> � �� /�,� ��� <br /> �! C � <br /> OwnerlAuthorizod Agant Signaturo Da�e (Revisetl?l20f 1� <br />