Laserfiche WebLink
a <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 />�C% APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />4DDRESS; PROPERTY�AX It PERMIT # <br />'S�''� �U��� I��.i�.41 1r:_i��.. ,.`-�`?iCJ C1 %r;,XJ .Z..G )� U�/ � � —Li�'� <br />L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />�l � �t"S � `-i � - E. 1 �(� <br />:R '�` 4� ' :, � � r-2,lJ '�- � 'j 1��� s :lu'7 �1...�L./.� Phone/E-mail � � / '4v:c���1 , h N <- "4�t-a , � ,"� . C..,;✓+"�'. <br />S� I`�' 1'�'��u;�-�s •1 :�H" ' �,�- I I cnyist�ceizP 1 b�ti,= °az„ti� �.�.Y�� ��� �� 13�,(.�' <br />PPLICANT: _ Owner V,� Owners Agent <br />i <br />ONTRACTOR ��'�.r�� �.,�^<-�,1� <br />�"�°?'� y � . �..� _� <br />idress �--•�w1 i i t,v ��'i i+� W l`�S �i ; <br />ENANT B SINESS NAME9 <br />� `�-4 " '•'� �. , �-�e'�r� 1.�., -�" <br />Contractor <br />._:,� J <br />Cl `? <br />CO�itr2Ci0rS Agetlt _ TBflafll (must provide e latter of wnsent hom the owner to do work In the spaca) <br />L & I Lic. # �.�'�, ��"� �✓' { � ��- ��C COE Bus. Lic. # <br />)'--t I � c<<_, _ `� �,� b — -� � ► U <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building `S'����--- i� J��: 5��� � rL; <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: _ New Addition Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />,-��,�.��, r--� • t <br />,� �"��= '���' \�`' \� \ <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteratlon _Repair <br />Show Number (#) o/ flxtures <br />A/C—air handling units <br />Forced air system; <br />heater <br />Unit h <br />Boiler <br />Other <br />� SUPPRESSION <br />Number of Heads <br />:UN 1 AG I tUK YtKMI 1 r"'� ``"� " -v' ``�.h./ � <br />-�J���S; t..���`� L_C_,ti.S��l I�. <br />'hone/E-mail �'���`� � �'i'� U�y�t-C::.:'7� l`i`��`.t')l . � �-L� <br />�S �T� <br />:ONTRACT PRICE OF WORK " 1 � �iL � � � , L� C_ �: <br />HEAT SOURCE: <br />I <br />Multi-Family � Commercial <br />T.I. Sian Sorinkle <br />of Use <br />�� ��, � �Z �`�(� <br />� �� , <br />3C> :� t�c� l <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of Hxtures <br />Toilet <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow prevei <br />Urinal <br />n <br />Medical Gas <br />Other: <br />Other. <br />n <br />I hereby certify that I have read and examined thls appliratlon and know the same to be true and correct. All provlsions of laws and orcllnan�s goveming this type of work wlll be complled <br />wlth whether specifled herein or not The granting of a permk does not prssume to give authority to vblate or cancal the prov�bn of any other state or bcal law regulatlng constructbn <br />That I am authorQed by the owner of this property to perfortn the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />.� � '' �. . �i�i,��.t�v -'�"� � � � <br />i� � <br />� <br />OwnerlAuthorized A nt Signature Date (Revised 6/2012) <br />