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 A�RESS2: r C^ � - PROPERTY TAX# P�1'j+lA1T#r <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER C Q G Q /.) F Phone/E-mail <br /> Address City/State/Zip <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 T C! 'JE i State Lie.# i-K f H City Bus.Lie.#p 6 <br /> Address `� 2 f f — ��/ Phone/Emailo ©ro g 5 S -] <br /> TENANTUSI ES3 NAME CONTACT FOR PERMIT,;>Z? PSC <br /> Phone/E-mail 36D 90 S <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK —2, <br /> Existing Use.of Building �, f" 1�, HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: r Single Family_Duplex__7ownhouse _Multi-Family Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Itis{AL� rwG A � c o9 /- ,D 64S <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: -Now_,.,Addn Alteration-Repair Type of Project: _New Addn Alteration`Repair <br /> Show Numberof fixtures Show Number of fixtures <br /> I AIC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavato wash basin <br /> Water heater~ Shower <br /> Gas fire lace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/barl etc. <br /> Heat pump Backflow preiventer <br /> Unit heater Urinal <br /> Baler DrinIdn5 Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other; <br /> Number of Heads Other: <br /> I hereby certify that t have read and examined this application and know the same lobe true and correct.AN provisions of laws and ordinances goveming this type of work ws be comp <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 1 am a ed by the owner gtthis property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> '/ '///'/w / 6/ 9 <br /> / �(" <br /> r/Ruth Ag nature Date (Revised 912014) <br />