Laserfiche WebLink
V1r-D rNI 6 D <br /> \*MDi- <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 /> *zSosig(2o iv3e.vo <br /> SITE ADDRESS: PROPERTY TAX# PERMIT <br /> rn�0� 1 t-� �(� SS tgvs�l9rx�in3�vv eAlt0 -039 <br /> tv�p—mr I of sc• : <br /> LEGAL for new construction: Short Plat/suudlvlslon Lot No. (attach copy of long legal description) <br /> OWNER I RTt'41.A Got' LLC. Phone/E-mail LLrKa)01/4a.1n e potiAritile knmer.&am <br /> Address 17921 607Nr41.,E1Mtsr rtu)y S U Tg IIv City/State/zip guru Eu- t Wi4• 148012- <br /> APPLICANT: <br /> 8f2t2APPLICANT:_Owner ✓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 SSG R'S cubliV-'G State Lic.# City Bus. Lic.# <br /> Address same aS R.bove. Phone/Email SaL tar at)OVe. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail SAS et a,bove.. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 23i1 $52. <br /> Existing Use of R„it r H11A HEAT SOURCE: <br /> , <br /> Proposed Use Of building_ AiTA C `TV'I/uN,1 '' Gas N'''. 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 /> JESCRIPTION OF WORK(additional space provided on the back): <br /> 149 "ICWW 1400 uInr b-& <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 /> 1 Forced air systems Bathtub <br /> Z.- Gas piping g Lavatory(wash basin) • <br /> I Water heater I Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range 1 Dishwasher <br /> 1 Clothes dryer I Clothes washer <br /> I Range hood 1' Water heater <br /> 5 Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump 1 Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain . <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> I Number of Heads Other: <br /> ..,,ereby 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 /> 9' �' 2091 V -vised 3/2013) <br /> Owner/Aut Agent Signature Date <br />