Laserfiche WebLink
� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERh11T SERVICES <br /> 32U0 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.evereitwa.org <br /> ��'. APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRE PROPER7YTAXp P RM� # < 1 � <br /> - 8�08 C� D -- �GS <br /> LEGAL lor new mnslmclion: Shart PlaVsubdivision t No� (attach copy ol long legal descripiion) �� n A n <br /> /'� <br /> OWNER / Phone�E�mail y � <br /> Addmss � � ,(t� JD�/r, � Cil//State/Zip A 7 0.37� <br /> CONTRACTOR /$ /J Y / �S I Lic.# E c,z 9�� �G <br /> Address SI�/��� a,s �QO(/E Phone/Email �S3 a 7Q �yy� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �1�;� � y <br /> ass- 9�i - yros <br /> PhonelE�mail C �� <br /> BUILDING PERMIT APFLICATION CONTRACT PRICE OF WORK <br /> Ezisling Use o(Building HEAT SOURCE: <br /> Proposed Use of Building Gas Eiectric_ other_ <br /> Ruilding type: �Single Family _Dupler_Townhouse _Multi-Family _Commercial 'I <br /> Type of projecl: _New _Addition _Remodel _Repair__T.I._Sign_Sprinkler_Demolition_Change of Use �. <br /> Destfiplion of W ork(addi(ional space provid.�d on�ck): � <br /> IJ � L' <br /> Have you startod workfng without a permft7 _YES LNO , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION i <br /> Typo of Project: _Now_Addn _Allnralion_Repalr Typa ol ProJocl: _New_Addn _Altnratloii_Repalr <br /> Show Numbor(N)o/lixlures Show Number(R)o/Rxtures <br /> � A/C—airhandlinguni�s Toilet , <br /> Forced air spstems 8athtub <br /> i� Gas piping Lavatory(wash basin) <br /> / Waler heater / Shower <br /> 1 Gas fireplace / Kitchen sink 8 Aisposal <br /> / Gas range / Dishwasher <br /> / � Clothes dryer Clothes washer <br /> / Range hood Water healer <br /> ; � Exhaust fan � Sink(service/badmop/etc.) <br /> � Heal pump Backflow prevenler <br /> � Unil heater Urinal <br /> � Boiler Drinking Fountain <br /> � Refrigeralion Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> � Other Mediral Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM o�ner: <br /> � Number of Heads I Olher: <br /> I hereby certily Ihal I have reatl and examined Ihis application antl know the same to be irue and correct.All provisions of laws and ortlinances governing <br /> Ihis rype ol work will be wmplied with whelher specified herein or noL The granting of a permit dces nol presume to give authonty to violale or wncel <br /> Ihe provision ol any other state or local law regulatinq wnslruclion or the performance ol conslruclion.That I am authorized by Ihe owner of lhis pmperty <br /> lo peAorm Ihe vm lo ic appl' tio i�tyade and I comply with the State Coniractors Law 7827 RCW and 296200 WAC <br /> � <br /> � � <br /> Ownorl uth I gent5lgnatura Date (Revised7/2011) <br /> `l L <br />