Laserfiche WebLink
PEI . 8T APP LICAT0 <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLED L),EM®LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wvvw.everettwa.org <br /> SITE ADDRESS: � 7f PROPERTY TAX ff P RMIT# <br /> r.�. t1� � �" ,� ' � ' )( 3 J <br /> LEGAL for new construction: Shkt Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER , /w2 7" Phone/E-mail <br /> Address City/State/zip <br /> APPLICANT: Owner _Owner's Agent _Contractor _Contractors Agent _Tenant(must provide a letter of consenl from the owner to Op work In the space) <br /> CONTRACTOR State Lie.# City Rus. Lie.# <br /> Address Phone/Email <br /> TENANT 13USINESS NAME CONTACT FOUR;PERMIT <br /> '� ily/tl Phone/E-mail /r X�f ���5/L�'�iT✓� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 /> z�l c C- ty fit �f�l- 71 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _Alteration_Repair Type of Project: _,New_Addn _Alteration rRepair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units j Toilet <br /> Forced air systems j 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 /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.Ali provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein not,The granti g 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 /> That I am aythorized y the ` er of this prop rty 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/AtilhoNzed Agent igna re Date (Revised 4/2015) <br />