Laserfiche WebLink
a'ERIinImT Af�PL,���4`TIC;a� <br /> �111LDIN�/MECH�4NIC�L/PLUII��INC/�IGN/SPRIt�MCLER/DEfViOL,IT60N <br /> CITY OF EVERETT PERM17 SERVICES <br /> 3200 Cedar St. Everett, WA 98201 425-25 -8810 FAX 425-257-8857 www.everettwa.org <br /> 17 �. � <br /> SITE ADDRESS: / � oPERTY TAX#i PF�2MIT# _ / � <br /> �_ �: � � �(� �i.�l�- <<� i'(' �, .-- <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER ��� /tr} i� �1;(. , 1 l Y_ Phone/E-mail <br /> �'L / <br /> Address l,�' (�C� i��.,� (� (�.L L City/State/Zip � ��.- i�L� �'i�''-�, �`� �C rC <br /> APPLICANT:�Owner _Owner�s Ageflt _COfltfaCtOf _CofltfaCtof�s Age�t _TO�aflt(must provida a letfer of consenl from the owner to dp work In the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> CONTACT FQR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ( y`l� �`'— 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 /> �-� � ��. . 3 �zG' �) ;��r � ,,� -� �-i � ��S -- `� (�E-�:-z �. t��, � � I <br /> t�E- �� i��c j � <br /> \ -�y / 1 G� 5 �� s� � � S — <br /> � J••, �'�I !'�.� S c i. --�'1.�'S c� �t.�� � S I r� / �' ' (�. 1 S � ��( <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 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 /> SPRIIVKLER / SUPPRESSIOId SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify thai I have read and examined this a plication'and know ihe same to be true and correct.All provisions of laws and ordinances governing ihis type of work will be complied <br /> with whether cifi�d herein or not.The gj ng of a permit does not presume to give authority to violale or cancel the provision of any other staie or local law regulating construction <br /> That I am a orized by the�+'ner of tf}is qr 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 /> ,//��L L. C--2.�. l-��.. <br /> l. <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />