Laserfiche WebLink
� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <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: PROPERTV TAK p PE MI 7 <br /> C�o akPs Z' <br /> LEGAL lor new conslrucuon�. Short PiaUsu�tlrvision Lot No_ (attach copy ol long legal description) <br /> OWNER q /f' . Phone/E�mad L/Z � �/G G <br /> Adtlress/� CjU�� Ciry/State2ip .��/�.�� �y 2c/ <br /> APPUCANT: _Ovmer OwneYSA9em Contraetor �ConVacloi'sAgeN _Tenant�mus�p�o�cvoie�re�mconsemrommuo+ner�ocohc;u�omospa:P; <br /> CONTRACTOR Ar�//e 1���s/1 / � Slate Lic NApA7//� L Cdy Bus. Lic # G S ��s <br /> naaresss .fy ✓e _ P�onNEmail t/ZS 3 7 /S�7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ��Zs� L//'7 — 7�7� <br /> PhonelE�ma�l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existin3 Use of�uilding_ HEAT SOURCE�. <br /> Proposed Use ol Builtling Gas__ Electric__ Oiher__ <br /> �wlding type: _Smgle Famdy _Duplex_ _Townhouse _Mulli•Famdy _Commercial <br /> Type ol project. New Adddion Remodcl _Repair _T 1. _Sign_Sprinkter_ Demolltion_Change of Use <br /> DESCRIPTION OF WORK�add�nonal space moviCen on me oacA): <br /> �a�i�f'(c� � ,� ���c�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Addn _Alteration_�epair Type ol Projecl: ,�Now_Addn _Alleration_Repair <br /> Show Number(N)ol lixfures Show Num6cr(aJ o!lixfures <br /> AIC—au hantll�ng units Toilel <br /> forced air systems 9athtub <br /> Gas pipin9 I Lavatmy(wash basin) <br /> Watcn c�aler � Shower <br /> Gas Greplace I Kitdien sink 8 disposal <br /> Gas rangc Dishwasher <br /> � Clolhr.s drycr � Clothes washer <br /> Range hood � � Watcn c�atcr <br /> Gxhausl fan Sink (service/badmoplelc) <br /> lieal purnP (3ar.h(low prevenler <br /> Unit heater I Unnal <br /> Doiler � Dnnking Fountam <br /> Refn9eiaUon Roor drain <br /> Woodstove Grcase Irap <br /> Ducling � Rool tlrains <br /> Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � o�her. <br /> Nurnber ol f leads � Other <br /> 1�c�c�y ccrl�ly ihat I�auc�catl anA c.ammc�Ihu appl.ca'ion on�l Anon iPe samc io Gc Iruc antl wncU All pionsion.ol law;and or0inanr,c;govcininq i��:typc ol work rv��Ec compi�c�] <br /> wnn wn�iner specdcE nerem oniot Ine yaniing ol�perme aoes ncI p�cume Iogrve aul�oiny 10 nolale or<anu:l me p�ovn�on ot any nmri siam cr lac�l la,v�cgula0nq mn:nutnon <br /> Tnal I am aut�mucU LY Nc ownet o'Ihu pion��ty lo pedorm InC wa�lor xtncA aPP':u�lion is made anA I mm01y w�R�Ilm Sl.i'e CunlraUors I.a.v 1 N.!NPlI in0 29G 700A N'�C <br /> OwnedAuthari[ed Agen�Signalurc Daic / (Revisetl]/707J) <br />