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# P IT# <br /> (DI O I Asso-u k{d gwA. Ets r i-f WA- `737,02) -?olf 0)00 0 0 5 0 -�"( /)q-Oi01 <br /> r <br /> LEGAL for new construction: Short Plat/subdivision _ Lot No. it 2. (attach copy of long legal description) <br /> OWNER ViiI f.,;rIt.)Ca (5/it,l+ (,tytd Ve,ift44F LL C Phone/E-mail _ -_ <br /> Address 'Pe 19:,-A 2,Li 12, City/State/Zip g Zil,t ,e, <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR S j'1Al-I+f rl(( S-1134(Pl S IOC, State Lic.# City Bus.Lic.# <br /> Address I I0 0 tVel Aie r;• Tattom4 WA 9t'y 2L Phone/Email(Zc3) ti 2to - I i3 t 0 <br /> TENANT BUSINESS NAME t CONTACT FOR PERMIT <br /> — <br /> qp <br /> rAso►l rvd,,t J,j Ie <br /> �I �s � M ( I&A (a� Phone/E-mail 4s2.)) L. -----t2p(o s/41 /f.Ce7wl <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK *311 <br /> 7 l ,5- <br /> Existing Use of Building \I 11 LUrtbt O V.S'e S h e t t /HEAT SOURCE: <br /> Proposed Use of Building C9 Ce. t.Jcf NNXt Sora lL' Gas X Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family X Commercial <br /> Type of project: New Addition Remodel Repair X T.I. Sign )(Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> A‘)41 L,W,S1701 ilk .S'rr;viii r S1iS ,A 4.-.0T ✓l2V0 0gLt. WAn/Ct1.1(vi/ Co;.� i,4,,e4ihi <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 /> 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 /> i 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 I Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove I Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 1'C-3 S Number of Heads Other: <br /> I hereby certify that I have read and . . .. cation'cation and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or not ' .granting of a p:rmit 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 authorize by a own- ofi.iS zpr.r.erty to pe'orm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> AntiI s �'Il <br /> Owner ^ ••rite •- t Signatur:� ate (Revised 4/2015) <br /> E 11L L <br />