Laserfiche WebLink
rERMIT APP�.ICATION <br /> BUILDINt3/MECHANICAL/F�LUMBING/SP�aM/Si�RINKLER/DEMOLITION <br /> CI7Y GF EVF.�2ETT PERAf�IT SERVICES I <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-SR57—www.everettwa.org <br /> ppPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PA� � ,_ ��// I <br /> tOPERTV p I <br /> ---�Sr �7� . /l�l -��z <br /> LEGAL for new construction: Short PlaUsubdivislon Lot No._ (attach copy of lang legal tlescription) .. <br /> OWNER C Phone/E-mail � �5���!��� <br /> Address �� -" ' Ciiy/S�alelZip � wA . �8a o� <br /> CONTRACTOR ,e L&I Lic.# {� L� <br /> Address �g9�3— -�- �• /v7 C PhonelEmail ,� �^'� �/� <br /> TENANT BUSINESS NAME NTACT R'P_EpRMIT <br /> Phone/E-mail (/ � � � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE UF WORK �!;'�-� <br /> Existing Use of Building �/ HEAT SOURCE: <br /> Proposed Use of Building _ cas ^ Eiectric_ O�her_ <br /> Building type: �Single Family _Duple;;�Townhouse _Multi•Family _Com�nercial <br /> Ty�% - of proJect: _New _Addition _Remodel _Repair_T.I._Sign,_Sprinkler_Demolition_Change of Use <br /> DeSCription of Wofk(addifional space pmvided on fhe backJ: <br /> Have you started wnrking without a perm�tT _YES �NO <br /> MECHANICAL PERMIT I�PPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProJect: _New_Addn Alteration_Repelr TypoofProJect: _New_Addn _Alteration_Repalr <br /> Show Numbei(N)oI llxtures Show Number(N)o!/lxNres <br /> A/C-air handling u�ils Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavato (wash basin) <br /> Water heater Shower <br /> Gaa fireplace Kitchen sink 8 disposal <br /> Gas range _ _ Dishwasher <br /> Clolhes dryer Clothes washer <br /> Range huod Water heater <br /> Exhaust fan Sink(service/barlmop/etc.) <br /> Heat pump BackFlow reventer <br /> Unit hea�er Urinal <br /> � Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstcve Grease trep <br />,� _ _ DucFng = Roof drains <br /> Other Medicai Gas <br />' SPRINKLER i �UPPRESSION SYSTEM _ Other <br /> Nom6er of Heads <br /> I hereLy cetlify ihat I haw�Pad and examined Ihis application and know Ihe same to be Irue and correcL All provislons of laws and ordinances goveming <br /> this lype of work will br:omp zd with whether specifed heiein or not.The granling oi: �ertnit does nol presumn to give authonty to violale or cancel <br /> ihe provision ol any o'her slale or local la regulaling consimction or the peAonnance of uuslruction.That I am aulhoiized 6y the ovmer of tLis propehy <br /> lo pedorm ih work lo•r�hich application made and I comply with the S�a�a Conlractors Law 18.27 RCW and 296200 WAC <br /> ��r.�� J� . �, �,�,1G4 //�-/� <br /> Owner/Authoriz Agent Sic�naturo Dale (Revised 1220f0J <br />