Laserfiche WebLink
PERMIT APPLICATION <br /> BUlLDING/IIAECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITIOt� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Sl., Everett, WA 98201 -425-257-8810— FAX 425-257-8857 —www.everettwa.org <br /> ApPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM 7 - 3 �I Z. <br /> SITEADDRESS: PROPERNTAX# PERM��S -O.�O <br /> (0 7 ue� c � � � sa�fih �'otn� 4.-:.� <br /> LEGAL lor new constmction: Short PlaVsubdivision Lot No._ (allach copy of long legal tlescriplion) <br /> OWNERp� C` .r � it1� �17;Cr H'G��1�5��5 PhonelE-mail y� ' l� � V�GZ7 <br /> Address � �/D� UC. /�1� Svl I` ✓ 3� CitylStale/Zip ,J��/(J� W • { ""V <br /> CONTRACTOR rP.t� � W�I.S CJc.'�i[�'� L&I Lia# C T <br /> Adtlress I�j . �`�(' ��LC�� SJ�"l". l�lF� �1N✓� Phone�Email 3l�j -336- 333�'y <br /> TENANT BUSINESS NAME ' CONTACT FOR PERMIT �,}. n `G�i I _ L. �S <br /> G�ViP/1���1 - C�-��CI�� r� T�GIst,1 <br /> PhonelE-mail � �y� ' �` I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE oF WORK���U <br /> Existing Use of Buildin5 A� l �11P C�Utl/�t''^'�" t HEAT SOURCE: <br /> ProposedUseofBuildingNl-�yWf�rin�l� �el ll-G�ii,�' Gasx Eleciric_ Other_ <br /> Building type: Sin91e Family _Duplex_Townhouse _Multi-Family �Commercial ��'� { j <br /> Type of projecl: _New _Addition X Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use ' ���Fa�} ,,1'd� <br /> � p �- c J�4 p�n <br /> Description of Work additional spaceprovided on the back): ReiM�` � Q�� �22���� f �Z�G` �• O" � <br /> ►aZw. -rti� ��;r�,.,� �� y 9q`1 S .�, b� -r�,�,+- �,�.�2 s ��. �:�c � ��,�a�� T�� <br /> b���d:q9 u� (I Se�G �c.� I:ff cs�, �- v�p„2hf. ,�0� I'1.��-� L�' �„3s. renan�l- ?Mr,,a-c �«,�- <br /> Have you started working wilhout a permil7 _YES �NO l,�<<I 7a= Se � �a'�F� j��f�� ��`(�s. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProject: _New_Addn _Altnration_Repair 7ypeoiProJect: _New_Addn _Alteration_Repair <br /> Show Num6er lM1 0l lixtures Show Number�k)o/fizfures <br /> I A/C—airhandlingunits Toilet <br /> � Forced air systems I; Balhtub <br /> �i Gas piping I Lavalory(wash basin) <br /> Water heater I Shower <br /> �� Gas fireplace I Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> ' Clolhes dryer I Clothes washer <br /> i Range hood � Water heater <br /> � Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heal pump I BacRflow preventer <br /> � Unit healer I Urinal <br /> ��� Boiler Drinking Fountain <br /> i Refrigeration I Floor drain <br /> I Woodstove ' Grease trap <br /> � Ducling I Roof drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ( other: <br /> � Number�f Heads �� Other <br /> I hereby certify Ihat I have read and examined this application antl know Ihe same to be lrue and correct.All pmvisions ot laws and ordinances governing <br /> ihi:lype of work will be complied vnih whelher specifed herein or not.The granting ol a permit does nol presume to give aulhority to violale or cancel <br /> the provision of my other stale or local law regulating conslruction or the pertormance of construction.That I am aulhorized 6y the owner of t�is property <br /> lo pedorm the work lor w�h application is made and I comply with Ihe Slate Contractors Law 18.27 RCW and 296200 WAC <br /> �����- ,���-� - Sl��l� <br /> OwnerlAuthorizad Agent Signature <br /> � Date (Revised?1107i� <br /> Z <br />