Laserfiche WebLink
IFERMIT APPLICATIC <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 /> z.?13 <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> "� <br /> 005/rZ, 40/00 000 'All l (-:' C'h j <br /> LEGAL for new construction:�Shhort Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER -G��F� ,i5. --// ' A/-774',/e/7--y Phone/E-mail /2 572,...s.—Z, qz z zi <br /> AddressZ /.5177 City/State/Zip&-- /e i/1 4./7419120- <br /> APPLICANT:, ' Owner _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 /1"/V GAS State Lic.# /-1./r>6,4-CL t`t 1U 1 Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail V2 S 293 5 6/,J 7i� 7— <br /> BUILDING PERMIT APPLICATION/� CONTRACT PRICE OF WORK /6O o. 4-0 <br /> Existing Use of Building 5-/-i, HEAT SOURCE: <br /> Proposed Use of Building 5/ --/e Gas i1 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 /> C letict 4ilAtv a 6 4 cuwiera� <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(#)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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain i <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 compl <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 auth ' ed by the wner 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 /> 1/4-1 9 // CI, <br /> Owner/Authorized Agent Signature Date <br /> (Revised 42015) <br />