Laserfiche WebLink
9ERMIT APPLICATIO <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 /> SIT KESS: yl LL <br /> Ldi <br /> ���}`i PROPERTY TAX# PARN�U#0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long leeg]al description) <br /> OWNERUVMR� Phone/E-mai Ztj ,a-- `� <br /> AddressAl VA' hwi Wh o—' *41 . City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent 4Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR !� State Lic.# L .DCity Bus. Lic.# <br /> Addres Phone/Email 16 . <br /> —� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT—TC) _, Tot `tEJi0�J <br /> Phone/E-mail I,�{���t� j �r�in�', � W <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �P <o <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 I Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK/�(additionalI space <br /> /provided on the back): <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 airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that Ihav read a d 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 comp <br /> th er specified h in or n t.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> uthorized by AT <br /> at er f this property to perform the work for which ppl' ation is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signature ate (Revised 4/2015) Li <br />