Laserfiche WebLink
• PERMIT APPLICATIO# <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# P RMIT# <br /> J[at) U 0069©57 60000 3 00 15 c 1 - C.)061 <br /> �1`,��G, <br /> TRACTLEGAL for new construction: Short Plat/subdivision OVA) AC e- L-et-No.. (attach copy of long legal description) / <br /> OWNER DI'L �.. I7LI O� Phone/E-mail 4Z5'*ot•'17oj D ler.}v� t/ v•C4w`- <br /> Address box 1,114- City/State/Zip EV F TT 1132.13 <br /> APPLICANT: Owner V 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 01.X) State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> K.tZi Tik) -!J OIV i42 •1741I11 <br /> Phone/E-mail kav►gortdesl' r a� Lorwt <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK JOS DDD== <br /> Existing Use of Building 'J p; __ HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: a•-' 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 /> kb D ATTA '!4Z. 5�• FT. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—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 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 compi <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 property 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 /> "FT <br /> stn ave rn • 1 •240 <br /> Owner/Auth rizati A lgnature t Date (Revised 9/2014) <br />