Laserfiche WebLink
P <br /> 00ERMIT APICAT104A L <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 /> SITE ADDRESS: PROPERTY TAX# PER IT# <br /> LEGAL for new construction: Short Plat/subdivision ?i Lot No. Z (attach copy of long legal description) <br /> OWNER Me VA— Phone/E-mail --ZS -27 <br /> Address 0�2, 5:7 "Ey- City/State/zip z�(Q <br /> APPLICANT:_Owner V—: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 State Lic. # City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT 13USINF-56 NAME CONTACT FOR PERMIT <br /> Phone/E-mail t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: T Single Family Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition _Remodel Repair_T.I._Sign_Sprinkler_DemolitionChange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New /Addn _Alteration_Repair Type of Project: _New-LAddn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forced air systems i Bathtub <br /> -- Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace i Kitchen sink&disposal <br /> I Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan j Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> { Boiler j Drinking Fountain <br /> Refrigeration i Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> j Number of Heads Other: <br /> I herebycertify that I h 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 /> 'ethr specifi d 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 /> T at I am auth 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 /> O horized ge t Signature Date (Revised 4/20.1.5)- <br />