Laserfiche WebLink
F'ERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-8810- FAX 425-257•8857 -Nnvw everettwa.org <br /> APPLICATIJNS ARE ACCEP�fED FROM 8 AM TO�PM rJ" ` 3 `--I <br /> SITE ADDRESS: � PROPERiY�%M 1 � PEfiM1T t l ., V <br /> 1327 IIZ �'^ �fi-ee}� SE z53o_ C,u f , IGC'D � ' I u�� <br /> ��.�:� � �1, ; __WI Nn_ (attach copy ol long legal desGiption) <br /> LEGAL lor new conslmclion Shorl PIaI�suD�frvision' 7 ,/ <br /> OWNER L �� ��C��`�C.II I�� C�� /(''f- , C"' Phonc�6mail ��2)' z��l '��Z�fO <br /> ) Z /^ r ` l f'+ . � .C' <br /> AOAress L J �� I)` •�•``l �=�' CtlylSlale/ZiP 1�� ` f�,\�t. ~-� � <br /> CONTRACTOR ���L I `il � t�� '�-> L 8 � Lic p <br /> il 17 r C-[- ._ /St7C�( <br /> C-� 1 ��7'� �':+ ��C1 �l <�L��-V+���i�� �1.L" � Phone'En�..�d �i c �- . UJ C.'�a <br /> Atld�ess .)�. � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> � �1�i� � �'� Ct��>1 ,/1(�,� , I Tc�:-S-fu� i. <br /> ,� Pha e�L-mad L� -4%� � � �7 <br /> BUILDING PERMIT APPLIGATION <br /> CONTRACI PRICE OF WORK_ Z:J ' �'0 <br /> �.� . n,� HEATSOURCE <br /> Exis�ing Use ot Bwlding__ —---- - <br /> ��� _ ���y Gas Elechic Olher <br /> Pmposed Use of Bwlding �'�� <br /> Bwldmg type _Single Famtl� _Duplez_Townhouse _Mutti-FamJy �Commeraal <br /> Type of pro�ect _New _Adddion _Remodel _Repart�T I _Sign _Spnnkler_Demoldwn_Change of Use <br /> DescriptionofWorklaod�tmnoisn++�ep�ov�nedonmveacN� _ C�Cr1re� 4�= <br /> � � � C[i� >�1`� ii � �I��i_Cli_ C�(l.t�iCr <�C� I� I�1�CVICi� ��y\ 1� �1�� � ���� <br /> �li; � � v-C� � ���� (� ��- <br /> i � 1� �( `.�. _� Y1,c'<ti� ( �� \� 1<`,1� < < � i1'� CLIti�C�� � C� '���C� Y �'IL�J �«� �x'dc' C'.�X �C"�-. � <br /> Have you staAed working without a permit7 _YES x NO (ZI j( r( �C � ����11�C'�"11�i:� � - <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typu ol P�o�act: _Now_Addn _A�toratlon_Ropalr TyDo ol Pro�oct: _Now_Addn _Alto�atlon_Ropalr <br /> Show NumDer(M)of(.fwer Show Number(M)ollirturee <br /> AIC- a�i handhng units To�let <br /> Fnrced au s r ems Bathtub <br /> Lavator Iwashbasin� <br /> Gas pi m� Shower <br /> Waler heater Kitchen sink 8 dis osal <br /> Gas hre iar.e D�shwasher <br /> Gas ran e Clolhes washer <br /> Clothes Ar e� Water healer <br /> Ran e hood <br /> E*haust lan Sink Iserv�ce�bar'mo /etc 1 <br /> Heat ump Backllow preventer <br /> Und healer Urm.al <br /> Boiler Drinkin Founlam <br /> � Refngerahon Floordram <br /> Woodstove Grease Va <br /> Ductin Rool dra�ns <br /> Other <br /> Med�cal Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other <br /> Numbei ol Heeds Olher <br /> I Iu�mLv'!'��'ty thdt I lil��e�eaA dn�r.a�ni�ivd Ih�s.lppLca6on;�nd w��mv Ihe sanle to be Inie en0 coirect AII provls�ons ol IawS anA ordina��ces yoveinmp <br /> mr,lyye ol woih wei be mmyheA w�lh whrUie�specd�ed herc�n oi nut ihe y�Ti�����g ol a pmmn does nol presume lo grve aulhonry to violale or cancel <br /> m��p�orsion ol any olher staie m local law regulatmg consimctinn oi Ihe perform�nce ol consVuctmn T�at I um auihonaed 6y Ihe owner ol Ihis propr�ty <br /> i„pr•ilo�m m.e wo�k loi which applicauon is maee..n�I comply with Ihe Slale CoNracto�s law 1B 27 RCW anU T9fi 200 WAC <br /> � �� �� �,�����I����' �Rev�5ec1:.:Oftl <br /> Ownor� ulhor od AgOht Signaluto ��'��" I^I <br /> \I 1/ <br />