Laserfiche WebLink
. • <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 />ITE ADDRESS: <br />�„ � _, . <br />for new construction: Short PlaUsubdiv <br />d E R�(;I�J n�Ori�.C.- G <br />:SS Zft blym�i c,T3lc�% U <br />LICANT: _ Owner _ Owner's Agent <br />RACTOR <br />dress <br />le <br />Contractor <br />� l.% I <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # PERMIT # <br />oo�o�z00004►oz � I 1�02- D1�1 <br />Lot No. (attach copy of long legal description) 7%. � <br />Phone/E-mail <br />�,3 I City/State/Zip <br />_ COf1�f2CiOf�S i�g2f1� _ TBfl2flt (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # ��� � �C�� � �,' � "? f� ty Bus. Lic. #� .� <br />'� <br />% �� � Phone/Email <br />CONTACT FOR PERMIT �c: <br />Gra�v�.Ca.�(� G��1o� �Iyl.t���r�-Cr <br />Phone/E-mail ?j 2� <br />CONTRACT PRICE OF WORK 'Yt �� I G�D(,�, �� <br />Existing Use of Building � i.��'i vrii" �O ���+v�taCs� HEAT SOURCE: <br />Proposed Use of Building i iVL?/' ��/�yl.OYtbD�LG Gas Electric Other <br />Building type: _ Single Family _ uplex _Townhouse _ Multi-Family _ ommercial <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) : �� �RL� <br />s� 3�ws:�n.-�t5 w ci�'► 8(�c.�� ��•-�as� rL�-Ytm�T � 3 Tn'1GZ-'s, <br />�'S� l F�'rC n��►�.e <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixiuies <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer (inside bld <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 goveming this type of work will be compl <br />with whether specifed 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 />Tha I am authonzed by the ner of this property to perform the work forwhich application is made and I comply with the State Contractors Law 1827 RCW and 2�J6200A WAC. <br />" � I 19-�20/(0 <br />OwnerlAutho e gent ignature Date (Revised 4/2095) <br />�I v <br />