Laserfiche WebLink
0 0 <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 /> AVEPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE(ZZ& ��OCjLJ(�� ( 11 � �(sz-b-jToo5q4-too-2oiTAX# too FERMI,1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER VC V J A) K)I LSOA Phone/E-rnail- <br /> Address ( c) - �jf i4 AOE,t6, 140KI LTCU City/State/Zip /(,!(��<I L.7f o \�/A e??) Z—7 S <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 /> CONTRACTORZAC« G7EGICE�'1" I'ISi-u �a C L& I Lic.# UIyUA�L g G COE Bus. Lic.# <br /> Address�,&((p 60LQ'( � UL (70 -4, Ell R Z Ll� Q`vZ©� Phone/Email `c z�j ' Oj z t Q Z <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> n v til IV14 v114 4ee8 <br /> Phone/E-mail P761 c,Q© C.C�tri) <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK !ac 00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric � Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New X,Addition Remodel Repair_T.1._Sign_Sprinkler ,XDemolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ,4r2fbe M t3r4r-�f — <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _X Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units 1 Toilet <br /> Forced air systems Bathtub <br /> Gas piping ( Lavatory(wash basin) <br /> I Water heater L Shower <br /> Gas fireplace { Kitchen sink&disposal <br /> Gas range Dishwasher <br /> I Clothes dryer 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 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 g ranting of a permit does not presume to give authority to violate or cancel the provision o f any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors L aw 18.27 RCW and 296.200A WAC. <br /> O er/Authorized Agent Signature Date (Revised 6/2012) <br />