Laserfiche WebLink
• 0 <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 /> SITE ADDRESS: E\ �e l� PROPERTY TAX# P RMIT <br /> � �AQ ��`;t' BJP e <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER p_ C( [ S C Phone/E-mail <br /> Address OIAOj ��« AA— , ��, City/State/Zip N\ C( � P) <br /> APPLICANT:_Owner __v Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> S <br /> Address Phone/Email tl 0 q Cl j <br /> TENANT BUSINESS NAME CONTACT FOR PERMITC <br /> C.�t.�i �� �� ��l'�-'U CLC Phone/E-mail � .��,V`e' , mcc, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF ORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric 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 /> Cup c� 1 <br /> t <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of roject: _New_Addn _Alteration_Repair Type f 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 /> I Gas fireplace Kitchen sink&disposal <br /> I Gas range i Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration ! Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j Other: <br /> Number of Heads 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 governing this type of work will be complied <br /> with whether specified 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 18.27 RCW and 296.200A WAC. <br /> Owner uthorized Agent Signatu Date (Revised 3/2013) <br />