Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857 —www.everetteva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM oZ �o��J `- II <br /> SITE ADORESS: �,� � PROPEftN TAX B P RMIT# _ OI� <br /> ,`.�?/5 ,Om l��r� .��, DD 7l/. OS60 <br /> LEGAL for new conslmcliore Shod PlaVsu�division Lot No._ (attach copy of long legal description) <br /> �J � r�r,o�e�e-mau "7S' 3��1 �l� � f�vi c6 .� �s�77 d iak�:�� ������ <br /> OWNER .l7 "i� Q-C,� i�' L �, y� <br /> Address �� 1wX � � CitylState/Zip ,�/1�{-t— �� <br /> CONTRACTOR �����?�qt� �� 7 / '��Evt. L 81 Lic. # <br /> Phone/Email <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 7��� �v ��,`�L�� <br /> / <br /> � ;� L / L PhonclE-mail �f ZS _S`�65�7�� < hl �f4rr l�'�«tr <br /> C����.w;� l�!<<rC'�(�i /Gart �s�ny.�- t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK t �7J �iU <br /> + / ' HEAT SOURCE: <br /> Existing Use of Building ��t �L-/1�'•i«t 2a�� <br /> �, �� v Gas_ Eledric . Olher_ <br /> Proposed Use of Building <br /> Building type: Single Famity _Di�plex_Townhouse,L Multi-Family _Commercial <br /> Type of project_New _Addition �Remodel �Repair�T.l._Sign�Spnnklar_Demolition_Change of Use <br /> Description of Work(addifional space provided on fhe back): <br /> �-�Y-��. ���G_.-.r�c �� .��'e- �x„�"� <br /> � <br /> Have you slarted working without a permit7 _YES _NO <br /> MECHANICAL PERMiT APPLiCATION PLUMBING PERMIT C,PPLICATION <br /> Type ol ProJect: _New_AL_.. _Altoratlon,_Repair Typo of Projoct: _New_Addn _Alloratlan_Repair <br /> Show Number(f�)o/Iiztures Show Number(#)o//ixtures <br /> � A/C-air handling unils � Toilel <br /> � Forced air systems Balhtub <br /> � Gas piping � Lavatory(wash basin) <br /> � Water heater I Shower <br /> I Gas freplace Kilchen sink&disposal <br /> � Gas range Dishwasher <br /> Clothes dryer � Ciothes washer <br /> � Range hood I Water heater <br /> .i I Exhaust(an � Sink(servicelbadmop(etc.) <br /> Heat pump � Backflow preventer <br /> Unit heater � Urinai <br /> I Boiler � Drinking fountain <br /> Refrigeralion � Floordrein <br /> Woodstove � Grease�rap <br /> � � Ducling Roor dreins <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> � Number of Heads I Other: <br /> I hereby cedify that I have read and examined�his application and know lhe sam=to be Uuo and corred.All pmvisions of laws and ordinances goveming <br /> ` this type ot work will be complied with whelher specifed herein or noL The granting of a permit does not presume lo give authority lo violale or cancel <br /> Ihe provision of any olher state or local law iegulating construction or the periormance ol consimction.That I am au�horized by Ihe owner of Ihis pmpedy <br /> to perform the v�erk�or whic applicalion is made and I comply v+ith the State Contractors Law 1827 RCW and 2962U0 WAC <br /> �,� ' .�� �' -- 2/�l-i� <br /> Uate (Revised 2l2017) � <br /> Ov+nedAuthoriZedif�ent Signaluro / <br /> ,� <br /> '� <br /> � _ <br />