Laserfiche WebLink
� c <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-6857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �a� �II <br /> SITE ADDRESS: ,D CDD ��F'�^'K E-� �_Ja PROPyER TA7( /� � PERMIT� <br /> J v^I L. 0 �`T0�7i 1�0 —� <br /> LEGAL for new consVudion: Short PlaUsubdivision Lot No._ (attach copy of long legal descnption) <br /> OWNER pr.�( /b (�/1:'/�� L`� Phonel6mail <br /> Address CitylState2ip <br /> coNrw+croR N �� 516�CU � L&ILic.# i✓' TdSC031�+'1 <br /> tlress 1 �r C . J[�! /�L %O�u PhonelEmail LO6 ZC���00 <br /> TENANT BUSINES NAME � CONTACT FOR PERMIT E � � F��r <br /> `/� �I�j/ O` �/�/� f PhonelE-mail ✓�LG�� �B S� ' [�� • �/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Bui�ding Gas Eiectric Other <br /> Building rype: _Single Family _D�plex_Townh:�use _Multi-Famil mercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I. Sign prink�er_Demolition_Change ot Use <br /> Description Of Work(additional space provided on the 6ack): <br /> Have you sGrted working withoul a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type ot ProJect: _New_Addn _Alteradon_Repelr <br /> Show Number(M)o/fixtures Show Numbar(M)01 flxtures <br /> AIC—airhandlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas pi in Lavalo (wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Ezhaustian Sink servicelbarlmo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Reiri eration Floordrain <br /> Woodstove Grease tra <br /> Ductin Rooi dreins <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify t t I ha iead nd examined l�is appliwtion and know the same to be irue and correcl.NI provisions of laws and or0inances goveming <br /> this type of wo �II mpf wilh whether speclfied herein or not.The 9rantlng of a permrt dces not presume to give authonty to violate or cancel <br /> ihe provision of ny t e 5 e or local law regulaling construction or the performance of wnstrudion.Thal I am authorized by the owner ot this propert/ <br /> to peAorm the r f i application is made and I comply with lhe State ConVactors Law 1B27 RCW and 296200 WAC <br /> �/�J� <br /> OwnerlAutho zed g tSignaWre Date (Revised2ROH) <br /> `,l '� <br />