Laserfiche WebLink
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: PROPERTY TAX# PFR° <br /> - ZI Z7 W5-r Ais,0" X116 • 0 —0q-' <br /> LEGAL for new construction: Short Plat/subdivision �v�� ;V77-Lot No. IS (attach copy of long legal description) <br /> OWNER e-1444CFf /4DA-A4-f0fVPhone/E-mail zVb -793-I fev / Mork-PA ' L' <br /> W <br /> Address 109,17 City/State/Zip 67V U64 - QJ'Zns" <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 0 W M6j2 L&I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT /AA �✓"fi,A v X-4 -5 Z)/Q <br /> Z66 - 7q3 -19 f t) d ' ! <br /> Phone/E-mail r^f dAJ /r l�7/ t" <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> I <br /> Existing Use of BuildingFA hEAT SOURCE: <br /> Proposed Use of Building Gas t,'--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 /> A-&A �w4.�'ti z-cater y�^a 9,Q t�i��-�i A-Gfp y a cmi-,r . <br /> MECHA..iCAL 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 /> j Forced air systems _ Bathtub <br /> j Gas piping -_', Lavatory(wash basin) <br /> j 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 I 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 Other: <br /> I <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.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified 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 /> CnerlA thorized Agent Signature Date (Revised 6/2012) <br />