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: PROPERTY TAX# <br /> 32© 5/Glst,tNE Pa.tvcC- GU5ao3 cata, 'fb-49 I ©2- 009 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER liikc,t E 6.04,12:61.1 Phone/E-mail (f 7. .-(Ora- I S-ts •b S NAOwo(/�f' <br /> Address 1 et(O rcn Jf City/State/Zip 5:11/aYsjQ )14- q e.2-44.) <br /> APPLICANT: C,ner _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.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �-�— -rr-t— q -'7-40— 4/W7 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /101 00 --- <br /> Existing <br /> `Existing Use of Building g/Ni-LrL V A-#-'k-tL.-v HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric k Other_ <br /> Building type: )dingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition ttILlemodel _Repair_T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): gewovE 14,N L- _ -770"/ - 'A . <br /> iff-ce c4/04-1- - (eAr-Pc-i-w-Ite <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn Alteration_Repair Type of Project: _New_Addn _EAlteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units ( Toilet <br /> Forced air systems 1 Bathtub <br /> Gas piping 2 Lavatory(wash basin) <br /> Water heater ( Shower <br /> Gas fireplace r Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood mt(110 { 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 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 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 prope to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. f <br /> 1 <br /> C <br /> 9001 <br /> torized Ag nt Signature Date /S (Revised 3/2013) <br />