Laserfiche WebLink
� � <br /> PERfiA1T APPLICATION <br /> BUILDINGIMECHANICAL/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 /> APPLICATIOt1S ARE ACCEPTED FROM 8 AM TO� PM �� . ab- 1 <br /> SITE ADDRESS: VROPERTY TA%p PERMITM I _ � <br /> C.O"t 3 <br /> LEGAL tcr new construcUon Shoh Plal/suDdrv�s�on Lo1 No (altach copy ol long legal Ecscnption) <br /> OWNER Phonel[-ma�i <br /> /+Edress r C�Iy/$lale2ip <br /> / 1 <br /> APPUCANT: Owoer Ovmer'SAgen1 �( Conlraclo� Conlratmr'sAgenl Tenanl�m„simmme.,�ere.mca,se,inomi�eo..�e•ioao..o+�,i+Psc.:�� <br /> CONTRACTOR L R I Li�. # COE Bus Lic �! <br /> AEdreSs � P�one/Ema�l <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE�mail ��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � 1��� <br /> Exisling Use of Bwldinq HEAT SOURCE�. <br /> Proposed Use of�wld�ng Ga; /Eiectnc_ Oiner_ <br /> Bviltl�ng�ype: �ingle Family _Duplez Townhouse _Multi�Famdy _Comme!uai <br /> T pe of pw-ect. New �dtlifion .�Remodel Repa�r_TJ Sign_Spnnkler_ DemoLhon Chan e ol Use <br /> DESCRIPTICN OF WORK(add�nonal space prov�ced on fne bacMl� <br /> \�c���.,�� �Wo �\«.��,V,,CA� <br /> MECNANICAL PERMIT APPLICATION PLUMBING RERMIT APPLICATION <br /> Typc o1 Pro�ed: _New_Addn _,�Altcration_Repair Type uf Projed: _New_AEAn _All¢ratian_Repair <br /> Shaw Num6er(q)o/(riures Shaw Number(9)of%rifures <br /> NC—air hand��ng unds TodM <br /> Forced an systems Bathlub <br /> Gas pipinq Lavato wash basin) <br /> Wa�er heale� Shower <br /> Gas fireplace I K�tcten 5ink 8 disposal <br /> Gas range I Dishwasner <br /> Clothes dr er I Cloihes washer <br /> Range hood ' Waler healer <br /> Frhaust fan Sink service/badrnop/eic. <br /> Heal pump Backflow prevenler <br /> Und healer Unnai <br /> 6oller Drinkmo Fountain <br /> RelnqcraUon Floor dram <br /> Woodslove Greasc Irap <br /> Duchnq Rool drams <br /> Other MeAical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> Numbur ol Heads Other. <br /> I liem�y cCqdy Illd���dve red0 dnU e�dmmed t�b d00�K�U0�dnd knOw I�e Same Io be INC anC coRep.All prpv�PJns olldw5 an�prQmJn[�5 gJveming inq p/OC 01 wplM wi I be compLeO <br /> w�n wl�elner speOGpe nere�n or nG T�e g�nbng ol d pprtnit aoes not pmsume lo gwe dulno�ty to vmlafe m cancel lne p�ov�sron ol any otnpr yt�1e or bcat taw regu�dimg consWciron <br /> ipai l am aw�onz �y the ��e 1��s propeM�o pedorm Ihe woM1 lor w�Kh aDV����I�on is made a�4 1 com��y rvnn tne State Comraclors La.. 1B 27 RGN, and:56 70041VAC <br /> f I ZD � <br /> Own lAuthori:ed gent Signature Oa1e (Rerised 6/2012J <br />