Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL/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 /> SITE ADDRSS: PROPERTY TAX# P MIT <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner _Owner's Agent K Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ! h State Lic.# S#Q(!,& City.Bus. Lic.# <br /> Address <br /> 'R <br /> t`a Ora 7� I PA7`41 i� C4 All <br /> ('�,0, ?) a, e ! WA- ��jro2 Phone/Email SY1��%Yl LC�/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT��� O <br /> A /0 a5r <br /> Pone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3500 00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel _Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Q MVV 6 0-0�1r— � �j � GGC✓w✓r� 1� 00�._ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_,Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units / Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace J Kitchen sink&disposal <br /> J Gas range Dishwasher <br /> J Clothes dryer J Clothes washer <br /> J Range hood J Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump J Backflow preventer <br /> f Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> J Ducting Roof drains <br /> J OtherMedical Gas <br /> I <br /> SPRINKLER / SUPPRESSION SYSTEM i Other: <br /> Number of Heads ! Other: <br /> 1 hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume togive authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent SignVile Date (Revised 3/2013) <br />