Laserfiche WebLink
%51(fi6N& 'G ' <br /> OtTC-2 <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 /> 2gOstgDoro3e.av <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> D W 1'111 P' SE Zg'D.s~19rx7/f73Y-01, Os --6 S <br /> LEGAL for new construction: Short Plat/su6dlvis on2 � +fit I I(J _ Lot No. (attach copy of long legal description) <br /> OWNER I&RTRL M cotLLG Phone/E-mail LerhelvlotkGtlA e t tCridgykoities.co,M <br /> Address 17 R'ZI tpw,u.,Em4.GIT t, 4)Y St tT6 Ifv•City/State/Zip god EU,_ , Wim. 480( <br /> APPLICANT:_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 SSG RS mbOV-'e State Lic.# City Bus. Lic.# <br /> Address WA. R.bUVa. Phone/Email Ste Af Q�o(1e. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail S-AM4-et Ot,boV� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 ►5 z t 51 a <br /> Existing Use of R„tial--- H�A HEAT SOURCE: <br /> Proposed Use ui miming 41AC4 4 -TVItatAS • 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 /> iESCRIPTION OF WORK(additional space provided on the back): <br /> M *ICWIQ 140M V& t-r C -2- <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 3 Toilet <br /> J Forced air systems Z Bathtub <br /> Z Gas piping 3 Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace -- I Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> J` Clothes dryer _� Clothes washer <br /> Range hood <br /> 4.. Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump I ( 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 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. 0' <br /> // Z3 • ZO <br /> Owner/Auted Agent Signature Date (Revised 3/2013) <br />