Laserfiche WebLink
PERMIT APPLICATICO <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: (LJ/ JO PROPERTY TAX# PERMIT# <br /> JO Li �, a oS���"9Z Do/e9 000 Pr <br /> 1C <br /> LEGAL for new construction:�Shhort Plat/subdivision Lot No. (attach copyoflong legal description) <br /> OWNER �G�F� Ur/�v . 1c% ,8� Phone/E-mail /2 T .S (J , qz z z <br /> Address74 Zdk /s-3(7 City/State/Zip G /« //1 X/74 9F20/ <br /> APPLICANT:,X 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 /9/.0 G/41/ ' State Lic.# <br /> ,4-1•Jr>�!)r-C le1t() I Z. City <br /> Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT,,qN� y //7/67 �e— <br /> gel/ //" `4J Phone/E-mail V229356 - 7-6,e7" <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /60 0, 0-0 <br /> Existing Use of Building J/ i� HEAT SOURCE: <br /> Proposed Use of Building --5F/ Gas X Electric Other <br /> Building type: _Single Family _Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition A/Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MALie afl. lLL <br /> MECHANICAL PERMITvAPPLICATION 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 /> Forced air systems Bathtub <br /> Gas piping 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 Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler 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 /> 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 compl <br /> with whether spe ' ed 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 auth 'z by the o ner of this properly to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />