Laserfiche WebLink
PERMIT APPLICATIO� <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITIQN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereh, WA 98201 -425-257-8810—FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C� �-��.(--�- <br /> SITEADDRESS: O �� � /�y�._ ^ ,e S �` PROPERTYTA%p O>I � '}D � P M�T� �OO <br /> _/— ��J <br /> LEF AL for new conslrucliore S�oA Plat/subdivision__ _ Lot No.____ (attach copy ot long legal descnption) <br /> �� <br /> OWNER� , �JY��( ' I� � PhonelE-mail <br /> Atldress � V � ��G' ,�''(,f: s Q ���U Cily/Stafel7ip C r'Y"E-�' (i(.(,�" �O � � <br /> CONTRACTOR ' 4 L� S � L 8 I Lic.t! 7 �. <br /> Atldress � �/ '['�� (�. � �� (�y;�T !d LV� Phone/Email LS � — <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT-�/� ("`� <br /> ��w � ����� PhonelE-mail KL.� ! /�LJ�p j5 <br /> BUILDI G PERMIT APPLICATION CONTRACT PRICE OF WORK_��__. ____ <br /> Existing Use of Building__�,�✓�i.['1'�.��11��I F __ _ HEAT SOURCE: _ <br /> Proposed Use of Bwlding _ _�___ Gas____ Eleanc____ other___ <br /> 8uiltling rype: _Singte Family _ Duplex_Townhouse _ Mulli-Family ,(lCommercial <br /> Type of projecl� __New __Addition __Remodel __ Repair___T.I._.�Sign__Sprinkler_Demohtion__Change of Use <br /> DeScriplion of Work(atldilional space p�ovitled on the 6ackJ: <br /> 1�lSi-lt.l��' (�, �/1CJl-� �� W�P S� <br /> Have you started working without a permit9 __YES __NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: .__Hew__Addn __Allerotlon___Repair Type af ProJack _._New__AdEn __Alterallon___Repalr <br /> Show Number N ol�xtures Show Numher�pJ o/lirtures <br /> A/C–air handlin unils Toilet <br /> Forced air s stems Balhtuh <br /> Gas i inq Lavalo wash basin <br /> Waler hea�er Shower <br /> Gas fire lace Kilchen sink 8 disposal <br /> Gas range Oishwasher <br /> Clolhes d er Glothes washer <br /> Ran e hood Water heater <br /> Fxhausllan Sink service/bar/mop/etc. <br /> Heat um Backflow preventer <br /> Unil healer Urinal <br /> Boiler Drinkinq Founlain <br /> Relrigera�ion Flaor drain <br /> Woodstove Grease tra <br /> Duclin Roof drans <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otn��: <br /> Number ot Heads Olhec <br /> I hereby cetlity Ihal I have iead and examined this apphwtlon and know Ihe same lo be Irue and wrrect.All pr�visions ol laws and ortlinances governing <br /> Ihis ty e ol work wtll be wmplied wilh vA�elher specilmd herein or not The granting oi a permit does nol pmsume to give aulhonly lo violate or canrxl <br /> Ihe pr vision ol Tny olher st�f�or lou�l law ie9ulating wnstruclion or Ihe pedormance ol wnstmclion.Rwl I am authonmd Uy the owner ol lhis property <br /> to e m rk lor vRuch apphcalion Is made and I coniply vnlh Ihe SWIe Conlractors I.aw 18.27 RCW and 296 200 WAC 1/ <br /> ( � � Z <br /> 0 nedA rized gen151gnature Da (Rev�sedTJT071J <br />