Laserfiche WebLink
PERMIT APPLICATI <br /> OiV <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 /> SITE ADD FC-e• I j� rERTY <br /> TAX# P EMIT* r <br /> LEGAL for new construction: Short Plat/subdivision \CAA �n" Lot N.,.• - (attach copy of long legal description) <br /> OWNER ?a c - \C \v\60\tU S. aJ - `--t y 9 <br /> Phone/E-mail <br /> Address W'I h \Q` v-ev e City/ tate/Zip --7/v‘ _'rte t\-'" NO\ 1 > <br /> APPLICANT:_Owner Owner's Agent X Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space <br /> CONTRACTOR v j'\--c cacb.\--- 'J l v,.\(1l lb t � <br /> ate Lic.# etcq c \�(QCity Bus. Lic.#06 S <br /> Address 1 - c)�` C--601— V�` '\`\\t(\� `� <br /> Z1.3 Phone/Email g(51bp"S- o <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -?e>47 0 -" - <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use ofofBuilding GasElectric Other^- <br /> Building type!` Single Family _Duplex Townhouse _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 /> N N) C % ci 0-Y\ \l'• _ O k a V <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> j Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> ' Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM I Other: <br /> 1t I Number of Heads Other: <br /> I hereby certify hat 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 corn <br /> with whether-,ecified herein or not.The granting of a•^rmit does not presume to give authority to violate or cancel the provision of any other state or local law regulating constructioi <br /> T la a •'zed• - ;loll. :_-y to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> (Owner/• 4 thori\d Agen , 4 ature Date \ f:71.....) <br /> (Revised 9/1014) <br />