Laserfiche WebLink
f <br /> �rERMIT APPLICATIO� <br /> BUILDING/MEC�ANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <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# PERMIT# <br /> 7L�1 l�7�� C% S c� ` J�✓"�v�-� `� ��L -(��,.,� <br /> . <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER -��;,,v�,�� C�t, .,'O Phone/E-mail �.Z��-Z.'>`�• Z�L� �.�, z 7 �•.''ti ',��-. <br /> Address C' � r�V. � - ��n�;�s; CitylState/Zip (�-���5.�.�r�� (,. y C ,S + <br /> APPLICANT: • Owner _Owner's Agent _Contractor _Contractor'S A9ef11 _T0f18f1t(must provide a letter of consent from the owner to do work in ihe space) <br /> CONTRACTUR (_h,�J��� State Lic. # City Bus, Lic. # <br /> Address Phone/Em�ail' <br /> CONTACT FOR PERMIT <br /> Phone/E-mail �l+�J`\C 1 � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2�U 0 --~ T • �� <br /> Existing Use of Building �n �'���� �%��t-�����` �.-��6-"� c�-} HEAT SOURCE: ,( <br /> Proposed Use of Building SC�s..� 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 /> �. �f U l� `�''��� i�...`C� U�!`lJ �� F ls', ( ,^"�ta�.;,� �''�ai�^w'+;;�(,. t �_- `W-,y"'� __•�-- C� J�'�' � • <br /> 1 _� . . � � � .. ��J � .. � <br /> t . �i r\U' � " • <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _N@w�Addn ,_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 basln) <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 j Backflow preventer(inside bidg) <br /> i Unit heater Urinal <br /> � Boiler j Drinking Fountain <br /> � Refrigeration Floor drain <br /> j Woodstove i Grease trap <br /> ! Ducting j Roof drains <br /> Other i 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 frue 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 compiy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> T <br /> �G�;-�'' G ,,.�-- z� S.�— <br /> Owner/Authorize gent Sig ture Date (Revised 4/2015) <br /> 4�� \1 <br />