Laserfiche WebLink
PERMIT APPLICATION <br /> c <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PR PERTY TAX it P RMI # <br /> 72//� iow .i( l4,ir'7- 7 �. <br /> 9iz 0 �U 374/00606F-3'e) / 014 061 - C 44) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER t// �7 16/J jj� r//Qw/7//' r V Phone/E-mail .1-.57-25---(P ,/loZZ z- <br /> Address 3m 7 ( Oz.‘y /MA. { 7iV // City/State/Zip Z-X4g,t/i4 <br /> 7 <br /> APPLICANT: V Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail Q) t 39 2 45/144/0I-vn/4.eie6 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ 4-8 .S I Z. <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 _Addition _Remodel _Repair_T.I._Sign_Sprinkler Demolition Change of Use <br /> DE,�CRIPTION OF WORK(additional space provided on the back): <br /> I <br /> orr <br /> .. .f /10/Cr/ S`/ 2//V , /r/r°'^G" l4///t/2 •4/ C.. <br /> - . &--(4 ,C� -,lit / 6 -'7 -/ ' ' - ' .0' -. ' r <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _Alteration_Repair Type of Project: _New_Addn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units j Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> INumber of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Nria <br /> � /000)� <br /> •Owner/Aut' "ried Agent Signature D <br /> Date <br /> (Revised 3/2013) <br />