Laserfiche WebLink
' PERMIT APPLICATION <br /> BUILDINGIMECHANICALlPLUMBINGISIGNISPRINKLERIQEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32D0 Cedar St., Everett,WA 98201 -425-257-9810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITEADDRESS: PROPER7YTl1%11 P �T�/� <br /> 3� R ��cl<� r- AV� <br /> LEGAL lor new construction: ShoA PlaVsubdivision <br /> Lol No._ (allach copy ol long legal description) <br /> K��, (7 PhonelE�mail 3�?-bCl� F�v��'�KCiy�o'CGir'C�iS"r � �t <br /> OWNER Ki I �� ,t <br /> ndAress ��,� �; ,, �C���"��� , `V'L. City151atelZiP LJC.i'L.-�'t' ��.�n C� � ,�' <br /> CONTRACTOR ��I�� L 8 I Lic.# <br /> Phane/Email <br /> Address <br /> TENANT BUSINESS NANiE CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION coNTRAcr PRICE oF WOKK <br /> �+ HEAT SOUF.CE <br /> Exisling Use of Building f P S� c,_{�����=r—?�.�(�P- �Y�tM�� — <br /> Proposed Use of Bwlding_ �eS ���'���L���� �`1"'��I� _ <br /> Gas� Eleclric�,Y Olher_ <br /> Duilding�ype: �SingleFamily _Duple:�_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition ,�Remodcl _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use rC`' <br /> Descrip�ion of Work(addAional space pro:ided on tho bnck): <br /> Rem.ve v,;�.�� i�crzl� a�ti hu�Id i�e�� l�acK I'� <br /> '� I'� �c� '.�t�i\C1 t-C•.�v\�)y IbC1Y1. 1ZC.i��ovc ���'ylf•�}�1'. <br /> remu✓2 w�c:lS+ov� . SnS-K�II <br /> c��tS <br /> {-,r�;.tc.-�L ii.id �,:: .���rio5 Ail tn (-am�ty �rclv\ <br /> Have you started working without a permilT _YES x NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa ot Projoct: _Now_Addn �Alterotlan_Ropalr Typn ot ProJect: _New_Addn _Alteratlon_Rapalr <br /> °how Num6er(4i a!/ixfures Show Number(N/o/flxfures <br /> � NC-airhandlingunits � Toilet <br /> Forced air systems <br /> Bathtub <br /> Lavatory(wash basin) <br /> � Gas piping Shower <br /> Waler heater Kitchen sink 6 disposal <br /> Gas fireplace Dishwasher <br />_ Gas rang� � Clolhes washer <br /> Cbthesd er Waterheater <br /> -� Range hood I <br /> Exhaust fan Sink(servicelbarlmop/etc.) <br /> BackOow preventer <br /> Heal pump � Urinal <br /> Unit healer Drinking Pounlain <br /> Boiler Floor drain <br /> Refrigerelion � Grease trap <br /> Woodstove � Roof drains <br /> � Ducting Medical Gas <br /> Olher <br /> SPRiNKLER 1 SUPPRESSION SYSTEM1I Other: <br /> � Numher o(Heads <br /> I Other: <br /> I hereby cetlify Ihat I have read and ezamined Ihis application and know the same to be We and cormc4 All provisions ol laws and ordinances ga�eming <br /> Ihis typo ol work will be complied wilh whelher speciGed hemin or not.The 5ranting ol a permil does not presume to give authority to violale or cancel <br /> the p�ovision ol any other state or local law regulaling conslruclion or Ihe pedormance ol conslruclion.That I am aulhonzed 6y Ihe o�mer of Ihis p�aperty <br /> lo pedorm the wor�C lor which applicalion is made and I comply with the Slate CoMractors Law 1827 RCW and 296200 WAC f,�� , ' <br /> �- / , ��� �I <br /> � �� � . � — 4. 7i i (Revisad?l10fi) �+ - <br /> O�vnodPUthorized Agent SI(naturo Date <br />