Laserfiche WebLink
PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNlSPRINKLER/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 />I ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />APP <br />SITEADDRESS: <br />PROPERTY TAX <br />PE fill <br />fill 3 <br />/09/ 3rd D", S� <br />LEGAL for new construction: Shod Plat/subdivision Lot No._ (attachcopyof long legal description) <br />Robert- Silt r <br />Phone/E-mail `'� �5 _ D 72 3 6 <br />OWNER <br />G✓¢u-(fi Q, 9 8 zo S <br />Address io I N 3rc, Dr 5C <br />City/state/zip <br />G <br />L & I Lic. p , -A & i 9 / 6O <br />CONTRACTOR <br />Address ))8,9 /`r C q b A L )/ 5' 03 PhonellEmail 25 p �l N �Ji <br />TENANT BUSINESS NAME <br />CONTACT FOR�IPERMIT <br />A iG kt yr a Zr <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION 1CONTRACT <br />PRICE OF WORK Li 13 9 <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building -as_ Electric__ Other_ <br />Buildingtype: _Single Family —Duplex —Townhouse _MUlti-Family _Commercial <br />Type o1 project: _New _Addition _Remodel _Repair _ T.I. —Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provide n the back) : q <br />rle,;S hGo/�IJ� <br />v'x's fa. LI ON& D <br />Have you started working without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn ZAlteration_Repair <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (N) of fixtures <br />Show Number (p) of fixtures <br />A/C- air handling units <br />I <br />Toilet <br />Forced airs stems <br />Bathtub <br />I Gas i in <br />Lavatory(wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />I Water heater <br />Exhaust fan <br />Sink (servicelbarlmo ielc.) <br />Heat pump /i <br />BackBow preventer <br />Unit heater <br />I Urinal <br />Bailer <br />Drinking Fountain <br />Reeration <br />fridslove <br />I Floor drain <br />Woo <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER/ SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />( 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 go!emino <br />this type of work will be complied twlh whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construcllcn or the performance of construction. That 1 am authorized by the owner of this property <br />to perform the work for which application is made and I comply wdh the State Contractors Law 10.27 RCW and 296.200 WAC <br />0// ice^ ,,,.-_i 1221//1 <br />Owner/Authorized Agent signature Date (Revised 212011) <br />