Laserfiche WebLink
• � <br />PERMIT APPLICATION <br />BUILDING/MEC:HANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., E:verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />�, l I/ S�7�Z-t/2 �'L /'�Je, PROPERTY TAX #1 <br />�' : �i � �7.�'Ji,)��t�• � G� c� C�/ <br /># <br />for new construction: 5hort Plat/subdivision Lot No. (attach copy of long legat description) <br />�1 � ' % �` <br />t �lYi1,6:�Z-/�� �,t��f.��J.(.�� � �i��L Phone/E-mail �ij�.� '� �J[.'" �/ <br />�• <br />�� G <br />� Owner _ Owr�ePs Agent v' Contractor _ Contractor's Agent , Tenant �musc provide a �euer or cansenc rrom me owner io do vb�c in me ePsce� <br />OR J�?-i� /�� %�% %���,�'� 1;..���_t. State Lic. #, X��(�/�%� �-/���� 1 Ciry Bus. Lic. # �53� � <br />�'�iSf (77c:.fl�:� <br />PERMIT APPLICATION <br />Phone/Email �C �, " �, j ��Cj ' L�y(� <br />w � rv�c rcrtin� � <br />� ' ,�c� - �%/�--L'<�� � <br />��C�ur�� �� <br />ail ;f /-�j::�tl�� �' ��,�'7<"tJt,rJr� <br />;ACT PRICE OF WORK I �i � . � <br />Existing Use of Building � HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ Other <br />Building type: _ Single Family _ Duplex Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ AddiUon _ Remodel _ Repair _ T.L _ Siqn _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additiona! space provided on the back) : <br />'� .(,t�C. �.,C! 1 � i.�1C,� � '' . ►�.�-�'"� Ci-��.C�. �(.�-�'YU �.�2.fz._ � `? }—�l�I � <br />� �� <br />MECNANICAL PEI�MIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Projact: _New _Addn _Alteration `Repair <br />Show Number (#�f �xtures <br />A/C — air• handiing units <br />Forced ��ir systems <br />Gas i ing <br />Water hf�ater <br />Gas fire �lace <br />Gas rancae <br />Ductir <br />Other <br />Number of Heads <br />of Pro)ect: „New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Shower <br />Kitchen sink 8 c <br />Dishwasher <br />Clothes washer <br />Water heater <br />I <br />ing Fountain <br />drain <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examineid this application and know the same to be true and correct. All provislons of laws and ordinances goveming this type of work will be comp <br />with whether specified herefn or not. The gr.�nling of a pertnit does not presume to give authority to violate or cancel the provision of any other state or local law regulatlng consWcUon <br />That I am�ized y)he owner of �s property to perform the work for which application is made and 1 comply with lhe State Conhactors Law 18.27 RCW and 296.20DA WAC. <br />� f �"�U„� � � � / <br />/�;�� <br />Ov(mer! uthorized Agent Signature Date (Revised 9/2014) `.� <br />