Laserfiche WebLink
• <br /> • <br /> 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 /> I/Ifl 1V <br /> SITE ADDRESS: foo SE L�Veae-�J /4 Il ltikcy PROPERTY TAX# PfTRi IT#D-72 s G� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 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 C t C B iA[I G C 1!S L State Lic.# City Bus. Lic.#are heti <br /> Address CE/utmo�,5 (AM Phone/Email 1 3/0(0 S <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Rt, w,a met.t.e n S <br /> C <br /> ca Q t e 1A-).�"' Com iict,n/ <br /> Phone/E-mail (3( C)3€-0E U d►ckve(tet('biehceii r ccc� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r1'6d/000 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 'vlf GtrO -77Y-,o,/,'..1(a Gas_ Electric Other <br /> Building type: _Single Family Duplex_Townhouse —Multi-Family Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Signa3prinkler_ Demolition_ Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> P.ewtoot't of 1✓l f ec1'0 r IAA 1/S J c <br /> lvts-kt..Yekton Ok. a int 1...) Ce.StrOC:M CAviC' tbt-et..-/ef y .mac. It hes �a <br /> �t <br /> i vi J c tej f -f ei (JF 7S, C ct Ce L J titll -64'vr ) a h Pate rt-;. <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 I Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <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 I 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 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 l am authrized 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 296.200A WAC. <br /> 07: <br /> � 3/9/ <br /> Owner/Authorized Ag •-• . e Date (Revised 9/2014) <br />