Laserfiche WebLink
PERMIT APPLICATION <br /> BUILD1 NG/MECHANICAL/PLUMBI NG/SIG N/SPRIN KLER/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- -2 <br /> 14 JPROPERTYTAX# P RMIT# <br /> o(,j r <br /> LEGAL for new construction: Short PlaUsubdivisionLot No._,Z (attach copy of long legal description) <br /> OWNER 1 LA- C, Q / Phone/E-mail T��_ S6 — -2 G X7 5 <br /> Address q f a _. / '2i E-7— is(/(} 4(!!�- City/State/Zip - v 2.ejtr `�t)A <br /> APPLICANT:—Owner ) Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR �' '� c�SC�S State9 �ilc.# City Bus. Li . <br /> AddressW CV S 4 S�;� Clr�1 Phone/Email <br /> CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building tn! f Gas_ Electric_ Other_ <br /> Building type: _Single Family _ uplex_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 sce provide on the back): <br /> /U 01-1:10 f^��( ��' fit-�4•.�; S `erg/r �_ <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 air systems i 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 <br /> Exhaust fan j Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer(inside bldg) <br /> I 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 i Other: <br /> Number of Heads Other: <br /> I hereby certify that I have_ d and examinpplication and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified h n or not.T-t7e granting of a per 't do of presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> Thatl-am authorized the ow of is rop y to pe e work for which appli ation is ma 'and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/ ut 6?i7 Agent Signture Dat (Revised 4/2015) <br />