Laserfiche WebLink
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 ADDRESS: / 7v <br /> i / / pop <br /> )cW 5 (PROPERTY TAX# I PeRM o D <br /> � <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER &L5U'/� Att_thpft_1-y of LY thPhone/E-mail <br /> Address Po • -6O X /54/1 Clty/State/Zip Eilcrt?t, u),4• 9 8,20/ <br /> APPLICANT: Ownerent Contractor Contractor's Owner's Agent Agent _Tenant(must provide a letter of consent from the owner to do work In the apace) <br /> CONTRACTOR SOtLI e ICY)e chCL n L c a.1 State Lic.# Solan.' 91505 City Bus.Lic.#4053301 <br /> Address (&Ob t 45t GP.4'4 > z g//lett, A 98 ao I Phone/Email ACV, "r!t7-o A`1.3 <br /> 'TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Le IAA <br /> Phone/E-mail 020(0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 't 42:2? 700 L' <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gats 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 /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 14dd 1p / Wad 6)4--+K�it) 5 y`S-1-e n7 — LA-11 L-h ORIc-n c.I Iyy �.1?5-t& /-P 4 <br /> does Nut- 'ne e p L.C.P r v,-tio L cyacl <br /> o� bt id z5 — &.nd hgs,Vo 4/C, <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(W)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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting_ Roof drains <br /> Other Q /V ,ea—C1.5 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 comp <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 a.r ••• •ed 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 296200A WAC. <br /> A. ./ '` <br /> Owner/ 'r'ud Agent Signature Date • (Revised 9/2014) �� <br />