Laserfiche WebLink
{. � - <br /> ` PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,W A 98201 -425-257-8810—FAX 425-257-8657—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM — 7� � <br /> SITE ADDRESS: ,� PROPE iY TAX M T <br /> 2✓I L �'�'.�L%FEC`6Q- �+VE 7 OZ4lo� � <br /> LEGAL for new construction: Short PlaUsubdivision �%� ���� � Lol No. uo (altach copy of long legal descnption) <br /> OWNER D�'v� S Fµ�� Phone/E-mail yS��7—�� <br /> AOdress Z."UZ �'ffkr��`� ^UE Cityl5lalelZip �11E.�-E�� (J��` • gZ°! <br /> coNrr�croR P✓CrCNLE� �E� �rCES L81Lic.# uNdAES�v3T�1 <br /> Address ���L3 /�"A�� 7� nr��-w�- �gZz� PhonelEmail yLS�pI�/1�7!'� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK NSH� <br /> Existing Use of Building �iC� HEAT SOURCE: <br /> Proposed Use of Building Gas x Elecvic Olher <br /> Building type: �ingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of projecl: _New D�l�ddilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Chanoe of Use <br /> Descriptiono(Work(addifionalspateprovidedonfhebnck�: '���,(�,i/(�, n/�W F'�},�E��qNd/�4 �i{AS i'`•�E <br /> � Have u started working thout a permltl _YES _NO <br /> MECHANICAL ERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typ of Pro�ect: _New Addn ,�jAlteratlon_Repalr Type ot Pro�ect: _New_Addn _Alteration_Repair <br /> Sh umber(M)ol�xturos Show Number(N)ol fixtures <br /> A/C—airhandlin units Toilel <br /> Forced air s stems Balhlub <br /> Gas pipin Lavato (wash basin) <br /> Water heater Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Cbthes washer <br /> Ran e hood Waler heater <br /> Exhausl fan Sink(servicelbarlmop/elc.) <br /> Heat ump Backflow even�er <br /> Unit healer Urinal <br /> Boiler Drinkin Fountain <br /> Refri eralion Floor drain <br /> Woods�ove Grease trap <br /> Duclin Roof drains <br /> Olher Medicai Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number o(Heads Olher: <br /> �hereby certify Ihal I have read and examined Ihis app�iwtion and knmv Iho same lo be Irue and correc4 All pmvisions of laws and oMinances governing <br /> this lype of�wrk vnl be complied�Nlh�Mether specified herein or noL The grenGng of a pertnit does not presume 10 give aulhonry to violate or cancel <br /> the provision ol a oth state or bcal law regulaling consWction or Ihe pedormance ol constmction.Thal I am aulhonzed hy lhe owner of Ihis propetly <br /> lo pedorm Ihi� fer ich applicalion is made and I comply wilh Ihe Slale Conlractors Law 1827 RCW and 296.200 WAC � <br /> �Z-_11�'�� ��S .� <br /> OwnerlAutho zad A t Signature <br /> Date (Revised 7/20f 1) <br />