Laserfiche WebLink
Zc�t�lr> <br /> 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 /> SITE ADDRESS: PROPERTY TAX ii PERMIT# <br /> , � ��L� _UC� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER�- ~- pa�,,,�=� -��M�— S Phone/E-mail L�ZS �-1�� - L-�GrC'� <br /> Address 1 z-� S;tie �J�Z,2� y�,b'�1.1� l.lJ� City/State/Zip r-��i�Z/Z,'I,I,['j� �v L�, • C)l`.c'�Z�� <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor�5 A9811t _T0fl8flf(musl provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR .a1�"T1X_ pti�,ti-�L� �-�-�='ia¢ S State Lic.#�r�,j �� - � �;� City Bus. Lic.# �'`` <br /> Address[Z:� 5 w �.._v �t,2�Z.•Z w �,,+i. Phone/Email 4 L� ��3 - Z..`ra'Gn <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ,_�Ot-4 tV �.2��l.�i-v�C, <br /> Phone/E-mail `���' �i� G-- 4 C✓+� �-- • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas 'J� Electric Other <br /> Building type: `L 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 /> �la v� <br /> ���� C, �- �?-D��j <br /> ���� <br /> MECHANICAL 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 /> I Forced air systems Z ! Bathtub <br /> ; Gas piping - j Lavatory(wash basin) <br /> d � Water heater + Shower <br /> � Gas fireplace ( i Kitchen sink&disposal <br /> � j Gas range � Dishwasher <br /> Clothes dryer � Clothes washer <br /> � Range hood 1 Water heater <br /> i Exhaust fan ; Sink(service/bar/mop/etc.) <br /> — j 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 /> j 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 state or local law regulating construction <br /> That I am authorize�by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> l <br /> C� 1 1 ' L '-� `{ <br /> O er/Authorized Agent Signature Date (Revised 3/2013) <br />