Laserfiche WebLink
• <br /> PERMIT APPLICATION • . . . <br /> • <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLERJDEMOLITION . . <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.arg <br /> • <br /> SITE ADDRESS: PROPERTY TAX# E(� ?� � — <br /> • LEGAL for new construction: Short Plat/subdivlsion Lot No, (attach oopy of long legal description) <br /> OWNER 5co4 - _5 i-v< Phone/E-mail i{- V-' 14` - Q 5-17 d <br /> Address .07 5t 24., p � V• Y� <br /> �SCity/State/Zip .CC 9 41 9-p. 1 <br /> APPLICANT: OwnerOwner's Agent Contractor Contractor's Agent .Tenant(mustprovda2letterofconsentfromtheownertodoworkintheepace) <br /> CONTRACTOR diLA A . A!f`AD.A State Lie.# ;;;:•'tz'et4N14•IJ/ :a City Bus.Lio.# <br /> t <br /> • <br /> Address t S , I - <br /> , , P1 5t. Hr yr{/ q'si E X. Phone/Ercall - 1p <br /> • d <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT . <br /> yttirllt! Nov.) pot,-.Pi-1V--'1100Phon®/E-mall ' -jt"•0 6 {-,,,,i tt no, • (tY19 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ► 10/) <br /> Existing Use of Building `S�FLZ HEAT SOURCE: <br /> Proposed Use ofBullding- Gas Electric Other • <br /> / <br /> Building type: ,! Single Family Duplex Townhouse Multi-Family Commercial • • <br /> Type of project: New Addition Remodel Repair / Ti. Sign Sprinkler Demolition Change of Use ••• <br /> • . <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 12c\06e ex - r q4 s - j ma c <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION • ' <br /> Type of Project; _New Addn 'AlterationRepair Type of Project: NewAddn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures • <br /> — • <br /> NC-air handling units _ Toilet " • <br /> i I �— Forced air systems Bathtub <br /> Gas piping _ Lavatory(wash basin) <br /> Water heater Shower • . <br /> • Gas fire.lace 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 heaterUrinal <br /> • <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 oertiry that I have reed 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 /> i 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 authorised by the• er of this property to perform the work for which application Is mads and I comply with the State Contractors Law 18.27 ROW end 286200A WAC. <br /> g I til <br /> Owner/Aut orized Agent Signature Date (Revised 912074) <br />