Laserfiche WebLink
PERMIT APPLICATION v 1 ' s-1 . <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 /> 2805-icr(20/03e.at) <br /> SITE ADDRESS: PROPERTY TAX# PERM T# I <br /> 1 30 `r 011 Pi E - ` Zrv. i9POIP3Y-Ov C VI-04.0 <br /> ��•I{dai of _Cr �►tJ r�- <br /> LEGAL for new construction: Short Plat/su6dlwslon , MA . Lot No. (attach copy of long legal description) <br /> OWNER tIORZWLIM COUP.-C' LLG Phone/E-mail LL z het vain B. pad Ac rid9C hvwctS.LW% <br /> Address 17'1 ZI Q01146t1. Ev aIT t 44)Y. sun"Ivo City/State/Zip gari4 Eu— r Uh4. (00(2 <br /> APPLICANT:_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 Sit ctS 0.b12vM State Lic.# City Bus. Lic.# <br /> Address Scuff as RA)oVQ. Phone/Email StZ.' AS R b Utj . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail $ AM?-ar ac,bovp <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $. ZZ 6 1 024- <br /> Existing Use of Reil,"_ I/A _ HEAT SOURCE: <br /> , <br /> Proposed Use ur building_ 4TrA 'IA)Rk e Gas Ne'. Electric Other <br /> Building type: ✓Single Family _Duplex ✓Townhouse V'Multi-Family _Commercial <br /> --Type of project: V.-New _Addition _Remodel _Repair_T.I. Sign Sprinkler Demolition Change of Use <br /> ,ESCRIPTION OF WORK(additional space provided on the back): <br /> 1451,0 Icww i•tot6 vo-r a-i V'$- I r a7-001 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ✓New_Addn _Alteration_Repair Type of Project: ✓NewAddn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units .¢. Toilet <br /> I Forced air systems 2 Bathtub <br /> 2. Gas piping C Lavatory(wash basin) <br /> I Water heater I Shower <br /> Gas fireplace , I Kitchen sink&disposal <br /> Gas range j Dishwasher <br /> I Clothes dryer _ I Clothes washer <br /> I Range hood I Water heater <br /> 5'^ 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 j Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> .,iereby 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 • Os: <br /> / % <br /> / 3- Z9«9 i/ 2 <br /> Owner/Author' , Agent Signature Date Rev'.•i 3/2013) <br />