Laserfiche WebLink
r <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:Q'yZ8 - fMr�h� ��� PROPERTY TAX# <br /> -• I G �- _ PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision <br /> Lot No. -"Oc� TIKJ F-i _ <br /> (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT;—Owner _Owners AgentContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do Jlh�p.,c.) <br /> CONTRACTORS rT` Z EI If J= ���•-r� I L&I Lic.#5 �i,JJ}FP a <br /> 3( COE Bus.Lic.AddressPhone/Email _TENANT BUSINESS NAMECONTACT FOR PERMIT a i = <br /> 34!-zy�7-�J&4 ;-� ,4 4n t-- <br /> Phone/E-mail G.y t L r r'� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ` <br /> Existing Use of BuildingLdfZ <br /> Proposed Use of BuildingHEAT SOURCE: <br /> _'I(1��.�(J i�.rg.L � `� ' <br /> Building type: Gas ElectriOther le Family —Duplex_Townhouse <br /> _Multi-Family Commercial <br /> Type ofproject: New Addition Remodel Re air T.l. Sin Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> i c�Ca;-COil <br /> �XiS'rlrtf, rime- is Pint= Sr—H Eo j A-. f <br /> MECHANICAL PERMIT APPLICATIONPLUMBING PERMIT APPLICATION <br /> Type of Project: —New—Addn _Alteration—Repair Type of Project: _New Alteration Repair <br /> Show Number(#)of fixtures — — <br /> A/C-air handling — <br /> Show Number(#)of textures <br /> units <br /> Forced airs stems Toilet <br /> Bathtub <br /> Gas pipin <br /> Water heater Lavato wash basin <br /> Gas fire lace Shower <br /> _ Gas range Kitchen sink&disposal <br /> Clothes dryer Dishwasher <br /> Range hood Clothes washer <br /> Exhaust fan Water heater <br /> Heat pump Sink(service/bar/mo /etc.) <br /> Unit heater Backflow preventer <br /> Boiler Urinal <br /> Refri eration Drinking Fountain <br /> Woodstove Floor drain <br /> Ductino Grease trap <br /> Other Roof drains <br /> SPRINKLER/SUPPRESSION SYSTEM Medical Gas <br /> 6 Number of Heads Other: <br /> Other: <br /> I hereby certify that I have read and 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 complied <br /> with whether specked herein or not.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 /> That I am authorized by the owner of this property 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 /> OwnAuthorized Agent Signature <br /> Date <br /> (Revised 6/2012) <br />