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# PERMIT# <br /> i(Q amt PI 6r G15o 3-0 .19 <br /> LEGAL for new construction: Short Plat/subdivisiorICASLA rt. PAQ-t1 Lot o. ) (attach copy of long legal description) <br /> OWNER S.Orrt c I ( tC_ k-s.-owt S Phone/E-mail (A25-\ctS3 2.%.01:3 <br /> Address i'2-0 s v..1 it J il:.fr- Mtiit.A._ LAn4‘-.i City/State/Zip J UT Imp, 1 2V 4 <br /> APPUCANT:_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 S\ p.11% i_ ??c-t,C-g .,. 1-k me-S State Lic.#5GATCptie ,$i3 L) City Bus. Lic.#1r03 -7.coio is <br /> Address S N.0&,1-4., Phone/Email 5t1/4t AL. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT .3-izz 4 Nt CP.AtA��Zci <br /> Phone/E-mail (447.5.\ 3•51: -- 4Qo 2.-- <br /> BUILDING <br /> 7..BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: t'Single Family Duplex Townhouse _Multi-Family _Commercial <br /> Type of project7t/New Addition ^Remodel Repair T.I.—Sign_Sprinkler.,,,,•_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1 c't S"€3 P L.A.,..) L CAL �3, QAC t c..., 28 . i 4 t t - o a t <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addy _Alteration_Repair Type of Project: 4Iew_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units '3 Toilet <br /> V Forced air systems 2. ' Bathtub <br /> 4 Gas piping 4 Lavatory(wash basin) <br /> Water heater i Shower <br /> t Gas fireplace I Kitchen sink&disposal <br /> V Gas range i Dishwasher <br /> t Clothes dryer t Clothes washer <br /> I Range hood <br /> t Q Exhaust fan V Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> r Unit heater Urinal <br /> - Boiler Drinking Fountain <br /> I Refrigeration Floor drain • <br /> — Woodstove --- { Grease trap • <br /> Ducting (.p Roof drains <br /> Other — Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM ! Other: <br /> I Number of Heads f 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 au ed 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. Iir)-2_ <br /> di. 3 -llc.✓1S <br /> Ow r/Authorized Agent ignature Date (Revised 3/2013) <br />