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# PERMIT# <br /> r)I zi Z-oc. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Ll L <br /> J -(:_ Phone/E-mail <br /> Address U a - ( City/State/Zip <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 /'/i L&I Lic.# COE Bus.Lic.# <br /> Address =:'> Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building oy)-40J HEAT SOURCE: <br /> Proposed Use of Building 4fnil C I Gas Electric'.' Other-- <br /> Building <br /> ther_Building type: K Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition _Remodel Repair_T.1. Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Pa i Ir <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Reg Type of Project: New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures / Show Number(#)of fixtures <br /> A/C-air handling uni s Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dj posal <br /> Gas range Dishwasher z/ <br /> Clofties dryer Clothes vyasher <br /> Range hood WaterAeater <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 / Other: <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 slate 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 /> //— <br /> 10wn.r1AtVho"r1)ized AAgen Signatur Date (Revised 6/2012) <br />