Laserfiche WebLink
� <br />� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />qDDRESS: PROPERTYTAX# P RMIT# <br />, �1 �320 �. C.��u �2oAd N�����z_�7�1r;: <br />LEGAL for new construction: Short Plat/subdivision <br />V P,�7L e Ow �ur S /a-SS � �"�'h �� <br />OWNER L/a ��p�rSori�S nrot�sv��l-c, N14�w <br />Address i 5� 3 I !VE 8� S�' Si�. ��'G �U <br />APPLICANT: _ Owner �Owner's Agent _ Contractor _ <br />CONTRACTOR (MGCCo�{ C.c9n S'f"Yu-�-'ho <br />Address ����j /� � 1�� SI'. .�(dii <br />Lot No. (attach copy of long legal description) <br />�.ytG„� Phone/E-mail �1�5.7�17•S�iW '���. � m, � <br />City/State/Zip �(�� �,� f � . ! (j (�C7� <br />COntf2CtOf S Agenf _ T0n8f1t (musl provide a letter of consent Bom the owner to do work in the space) <br />LC L& I Lic. # �fl/� EOCLQSI D COE Bus. Lic. # <br />(��. , Phone/Email 2�, 6e}5, �837 <br />CONTACT FOR PERMIT �� � L/ � J Z�NS� ��,� },<. <br />�� � Vl� 'e � , r "' Phone/E-mail ��-5� 2�{i3• �723Z <br />BUILDING PERMI APPLICATION CONTRACT PRICE OF WORK �( Z� 4�oZ • �Ilo <br />Existing Use of Building �G��i%/ �"f�'�'lPLj'' iQ,�'S"!/>€7t�%�/�Z HEAT SOURCE: <br />Proposed Use of Building %`/t.r ��9`'/9'� �� Gas Electric Other_ <br />Building type: _ Single Family _ Duplex _Townhouse X 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 />I�- ��'f= t/�. I✓'v v/2. K. f� � D %? E`� !'� .S U� i'�T" < f" <br />! �} 3 �'/�r �r /t�J v �: � — r�.�t�-i �G�'' �.ES'i�a�i�'a9G �'r,�'"r�Gt'>r' <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Numbe� (#) of fixtures <br />� A/C — air handling units <br />I Forced air svstems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />� Other <br />PRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />I Bathtub <br />Shower <br />Kitchen sink & <br />Dishwasher <br />Clothes washe <br />Water heater <br />Sink (service/t <br />Backflow prev� <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />n <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 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 />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />( 2 �2� I 3 <br />Owner Authorize Agent Sig ature Date (Revised 6/2012) <br />� �Z <br />