Laserfiche WebLink
i'ERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITIOId <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 ADDRE�S: PROPERTY TAX q , . PERMIT# 7 <br /> _.�"�'. / //r'/'✓c'' SJj (- �i'"/�'� �r%=� �-/S``���:�c?/ t'�:� �.%t�' ����c� � � <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER E'[/�/��� Q!/,��/✓� (� ��/��` Phone/E-mail ��,�G�,�' � L /� <br /> Address .7/U / (—Q�.0 7 ��(�� � City/State/Zip �l���� <br /> APPLICANT: �Owner _Owner's Agent _Contractor _Contractor�S A9@fl� _T@I18f1Y(must provide a letter of consent from the owner to do work in the space) <br /> � `�/t� �'��' /� State Lic.#(rs✓r�L�!'r�/�('(���(1�/ City Bus. Lic.# ,(.�.f �r <br /> CONTRACTOR � / " �` ,� e <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �? �-'" <br /> �/ / Xo� N�� � <br /> 4,�����"���1,�� ,�f f Phone/E-mail �L�vr`J�� 6...��� /�CJ/(�/��l/ ����� ���7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ���'- R� �j . ''-'' <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._5ign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additionaf space provided on the back): <br /> .�/.�o✓�/�l�� <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 fixfures <br /> A/C—air handling units ! Toilet <br /> Forced air systems ; Bathtub <br /> j Gas piping � Lavatory(wash basin) <br /> � Water heater � Shower <br /> � Gas fireplace � Kitchen sink&disposal <br /> � Gas range ; Dishwasher <br /> � Clothes dryer j Clothes washer <br /> Range hood � Water heater <br /> Exhaust fan � Sink (service/bar/mop/etc.) <br /> Heat pump � Backflow preventer <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 j Other: <br /> Number of Heads I Other: <br /> I hereby certify ihat 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 specified herein or not.The granting oi a permit does not presume to.give authority to violate or cancel the provision of any other state or local law regulating consfruction <br /> That I am ut rized 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 /> ,...—.. , y I�� `�/� \) <br /> �'- ,,,��-� ���_ � <br /> Owner/Au ri d Agent Signature Date (Revrsed 3/2013) <br />