Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8610—FAX 425-257-8857 —www.everettwa.orgr� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a — 2S �/Z <br /> SITE ADDRE55: —, PROPERT� AX11 C, _ PERMITt ,L_ <br /> .<;� iS f/�� ��-� '�l v�,r��� c�, � a� � z � � 03 <br /> LEGAL lor new conslruclion: Shoh Pla�subdivision Lot No._ (attach copy of long legal description) <br /> OWNER ilC� �j�( � (; L C C phonelE-mail �I�S'�39�S��1S <br /> Address S y•� S- 1 S�'q~ S %. S��E CiIylSlate/Zip .y- .4' o,-+ �S� c.;/i %�2`>d� <br /> CONTRACTOR �-- I�71 U�'[-k�' ✓ L61Lic.# Cr.rn'�� � <br /> � <br /> Address `;j`/?S 1 SC� S � f �" � '�i�<i'"i1 1 S:-�( PhonelEmail �-/21 �.Z3 � 'SL /S <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �,77(� /1'� S F � �� L C,O 1� $_ Phone/E-mail <br /> BUILDING PERMIT APPLICATION CON7RnCr PRICE oF WORK <br /> Existing Use of Building � �' HEAT SOURCE: <br /> Proposed Use of Building Gas_ E�ectric_ Other_ <br /> Building lype: Single Family _Duplex_Townhouse _,Multi•Family _Commercial <br /> Type of project _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Desc�iption of Work(adde�onal spaco provided on fhe back/: ( � <br /> FYc�Lt �" CcUvPo"' � Sil'btG�Il�' QI'DI.tY1Cl, l/�I'�I I <br /> Have you slarted working without a pertnitY _YES `�NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typoo(ProJoct: _New_Addn _Alteration_Ropair TypeolProJocl: _New_,Addn _.Altaratlon_Repalr <br /> SAow Num6er(N)o!/ixtures Show Number(N)oI flxtures <br /> A/C—air handlin unils � Toilet <br /> � Forced air s stems I Balhtub <br /> � Gas piping Lavato (wash basin) <br /> Waler heater Shower <br /> � Gas fireplace Kitchen sink 8 disposal <br /> � Gas range Dishwasher <br /> � Clothes dryer Clothes washer <br /> � Range hood Water heater <br /> Exhaust fan Sink(servicelbar/mop/etc.) <br /> Heal pump � Backflow prevenler <br /> � Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeretion Floor drain <br /> Woodstove I Grease trap <br /> Ducting Roof drains <br /> I ��,i c�u Ni � � ��' Medica�Gas <br /> Other '] C/�il' " <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> INumber of Heads I Other: <br /> I hereby cenily Ihat I have read and examined ihis application and know the same to be true and correcl.All provisions ol laws and ordinances governing <br /> Ihis rype ol work vrill be complied wilh�vhelher specifed herein or not.The granting ol a permit does not presume lo give authori�y lo violata or cancel <br /> Oie provision of any other slale or local law regulaling construclion or the pertormance of cons!mclioa That I am aulhorized by the mvner of this propeAy <br /> to pedorm tho work for which application is made and I comply with the SIa1e Cantractors Law 1827 RCW and 29G100 WAC <br /> . i — ) . � G �� � /C' .-, t� _ // <br /> OwnorlA hdFized �gan[Signaturn Dale (Revised7R077� I�Z <br />