Laserfiche WebLink
I <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 /> SITE <br /> E <br /> IDS: IiU�LNO T. S.172C�T PROPERTY RR5�[A�33150 O goo PERMIT# <br /> ( 1-102-006/ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �}/►1 es C7 G Phone/E-mail =r/I%' ifT - ff c Ar <br /> Address 5& g co"— ��c c-e /t�F City/State/Zip 711,5a ke4 . 9 o 2_7 6 <br /> APPLICANT: VOciner _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 State Lic.# Ce41 �7City Bus. Licc.'�# <br /> Address S 4:—F Phone/Email i-11.5 ^32-9--- -D15 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 3/r pE L P Gj <br /> Phone/E-mail St rfq e�d'a�c5 /.91 309,41^['Cool <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 30A,000 <br /> Existing Use of Building 1 • a-( HEAT SOURCE: <br /> Proposed Use of Building ite-wir;--, 4 P.ex Gas_ ElectricA' Other /a r <br /> Building type: _SSiirSgfe Family —Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: K New Addition _Remodel _Repair_T.I._Sign irprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ut( f i{--/2ie-)e /.,/ N T /,6F oLP Oi4 5 -. 6' A-C.LE r, <br /> e1?-e rci-� '2. et-e e C.om�le r'vim o '' 4- pLK) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair Type of Project: VNew_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> r A/C-air handling units $ Toilet <br /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater it Shower <br /> Gas fireplac W Kitchen sink&di %•sal <br /> Gas rano Dishwasher <br /> lot - dryer y •thes w-- er <br /> ge hood y Wa : --ater . <br /> x -ust fan Si - s- ice/bar/mop/etc.) <br /> Heat ump Backflow eventer <br /> Unit he er Urinal <br /> i Boiler Drinking Foun :in <br /> Refrigeratio Floor drain • <br /> Woodstove Grease trap <br /> Ducting ; Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM I 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 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 constructio <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 W . <br /> 1 ti)i <br /> O er/Authorized Agent Signatu;.( Date (Revised 3/2013) <br />