Laserfiche WebLink
' cc 6 -4 <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 /> 2.SOSJggco 1193e.PO <br /> SITE ADDRESS: PROPERTY TAX# P R T <br /> H. L0 sm_p�- S.. Z�v. Alt; er C( -®S) <br /> P��,,,,� <br /> LEGAL for new construction: Short Plat/su6dlvision� cr. Lot No. (attach copy of long legal description) <br /> OWNER l Tt4141M COIVT I-LC. Phone/E-mail Le z het VIVA A L igttiPtC rl d e kowips.Go,M <br /> Address 17cfZi t011 .l,EVet4`t1 t4)VV. SIMS.li'City/State/Zip gi9Eu, t IA.1i4-. (010 t 2APPLICANT:_Owner ✓Owner's Agent _Contractor Contractors Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR 5 :1444t RS 0.bpve+ State Lic.# City Bus. Lic.# <br /> Address SCUMQ as above_ Phone/Email Scout tar RbEVe <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail S.AA -a r a'loove. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK - 1 8!t, $.8 2.. <br /> Existing Use of R.'"'"~- N/A HEAT SOURCE: <br /> ` <br /> Proposed Use ur rsullding_ 4TrA 4, 6 . <br /> Gas Electric Other <br /> Building type: ✓Single Family Duplex ✓Townhouse ✓Multi-Family Commercial <br /> 5,---Type of project: ✓New _Addition _Remodel _Repair T.I. Sign Sprinkler Demolition Change of Use <br /> iESCRIPTION OF WORK(additional space provided on the back): <br /> 1491.0 1CWIJ i4o1a6 ukry ' & -4 <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 /> NC—air handling units 3 Toilet <br /> Forced air systems Z Bathtub <br /> / Gas piping 3 Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace / Kitchen sink&disposal <br /> Gas range / Dishwasher <br /> Clothes dryer / Clothes washer <br /> Range hood r <br /> ¢. Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump / 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 /> Number of Heads I 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 RC ...'6.200A WAC. <br /> /001 9,4r- roil/ Yz . <br /> Owne horized Agent Signature Date (Revised 3/2013) <br />