Laserfiche WebLink
• � <br />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 ADDRESS: . PROPERTY TAX # PF161M1T # 1 <br />� Z�� pc.�r����� �<�r w/�- j c� c� �`13 Ztvv ���/c�, fj���'Cl L- C� �� <br />LEGAL for new construction: Short Plat/subdivision__ae�" _ N/Lt�_� �� .�,Lot Na_____ (attach copy of long legal description) <br />OWNER G f� � t y j/J-L Z <br />Address 5 Z v`-' (� �C-��'1- Zi a�L �„ <br />APPLICANT: _ _ Owner �Owner's Agent _ <br />� �' _ <br />Phone/E-mail -�-- <br />cityistateizip �� �-i �'�'TT� , c�- �1- `'1 z� `�- � 3 <br />COf1iC8CtOf __ _ COf1�f8CtOf�S Ag21lI ___ T8l18111 (must provide a letter of consent (rom Ihe ovmer to do work in Ihe space) <br />CONTRACTOR C� �i- I—� AI �T�- State Lic. # City Bus. Lic. # L1�J' <br />Address L 7 � � � �-���`� "�% _ t v � ^�:_.� ; � �� � � � � Phone/Email � � Z � � � � � ` � �GSb <br />'� �1 � � � ��=�� e <br />BUILDING PERMIT APPLICATION <br />�1 c� S S � �2. c 1� /�i�rl`� 1?` LTJ R-t� <br />Phone/E-mail C✓'G S S ��- Z` (�. ci y c-� �• �`e-� �-v�- , C--o � <br />CONTRACT PRICE OF WORK � S�'' �� �� r <br />Existing Use of Building __� �'v1- f> �'��-�n-s' I/ C�' _ HEAT SOURCE: <br />--- -------------------- <br />Proposed Use of Building_ C�al w__`f7�-�f"z-�*� (r' � <br />_______ Gas _ Electric_ ___ Other____ <br />Building type: ___ Single Family __ Duplex __Townhouse __ Multi-Family �Commercial <br />Type of projecL ___ New ___ Addition ___ Remodel � � epair �;T.I. _ _ Sign _ _Sprinkler _Demolition_ _Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />`"C C!L. rrb`-= 'i 1°�'� G� ��' "� t�.-�= �`� T. -/� D►7 r^- Z�--% T3 � 7 r �<� � A ti° r� /L- r'Zt, <br />S 6l o.:� E_ �'�- 2�' •� .- � i�►z e� _ 1, n S" S. F". <br />A� iF �✓ /j- l2 �4 f' LT7 S Z c r� `�'= �:_� £3 � l� I II` C� <br />�' <br />��-t�p-i�.r� - . <br />� n-�� �c_� �3 � �- aJ i �4 - �..t �(,,''�•-� C - (? � �! � ` a � {� �' �� � �° /.r �: u� :� � C_ <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: ___ New _ _Addn ___Alteration ___Repair <br />Show Number (#) of fixtures <br />A/C - air handlin units <br />Forced air s stems <br />Gas pipin <br />Water heater <br />Gas fireplace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER I SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _._ _ New ___Addn __„Alteration _ __Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavato wash basin <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink service/bar/mop/etc. <br />Backflow reventer <br />Urinal <br />Drinkin Fountain <br />Floor drain <br />Grease tra <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know lhe same to be true and correct. All provisions of laws and ordinances governing this type of work will be comp <br />with whether specified herein or not The granting of a permit does not presume to give authority to violale or cancel the provision of any other state or local law regulating construction <br />That I am authonzed by the owner of this prop to perform the work for which application is made and � comply wilh the State Contractors Law 18.27 RCW and 296.200A WAC. <br />---�-� �ti. _� � ti <br />nerlAuthorized Agent S' ature Date (Revised 9/2014) �?j <br />