Laserfiche WebLink
• • <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 /> u�3-, S <br /> SITE ADDRESS: PROPERTY TAX# PE IT# <br /> �I�i 30 \1 � 1 ' y t3 2Q:04 i'*330CACO 1.50 3 -- 012- <br /> 7 cQ <br /> LEGAL for new construction: Short Plat/subdivision l / Lot No. -. (attach copy of long legal description) <br /> OWNER DAL)(S PrZOfoe-iZ-'(-I Est J L ) Phone/E-mail (z0(0) 6,01 ` ar, '7 <br /> Address ( Q 72. <br /> 5 /14..) --- 10 G.- City/State/Zip K 6-00404(., � (4_44 <br /> APPLICANT: f/ 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 WI I I 110 rv) Torn p S Ly Cor 51 State Lic.# W I LL1 DT' ( POCity Bus. Lic.# ��/ <br /> Address _ti)n r N/0Qk Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> pr 4t 1, P2-ti(a . <br /> PAIzo 6A- c.t_t=k E Phone/E-mail tcasts Deiic thf t5•PAGC ,C.O�vt <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKT2.1 1 01:20r7 <br /> Existing Use of Building e"'Ffie-eS HEAT SOURCE: <br /> Proposed Use of Building -111-p14 L) *Orr Lr/E5 Gas Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family ) Commercial <br /> Type of project: _New _Addition Remodel _RepairJO T.I. Sign_Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 17--5"4d 1DT1a.1 Off' I t f ir42-t '44c-c..- aF' APPP09‹c h r't 1E1 � SF <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 I 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 j Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump J Backflow preventer <br /> Unit heater I Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration N 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 th- -v- ead 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,•ecified here or not.The• - ,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 authorized by t owner of this property o perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> • <br /> 17 � i�� �� _ 1z?zap( <br /> 0 er/Authorized Agent Signature Date (Revised 3/2013) <br />