Laserfiche WebLink
• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBI NGISIGNISPRINKLER/DEMQLITIQN <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: ERTY TAX# P IT <br /> 3 15- � e, Avt1PROP,7go-5-300030b/00 , c) - 5 <br /> LEGAL for new construction!`/Short Plausubdivision Lot No. (attach copy of long legal description) <br /> OWNER t G�} v S�Q f Phone/E-mail „ �- 3 3 O - y7 b <br /> Address ,j City/State/Zip E"ve-tcf q 10 <br /> APPLICANT:_Owner _Owner's Agent )(Contractor ____Contractors Agent _Tenant imus?provide a lever of rx nsent from the ovr erto do rm,k in Inc space) <br /> CONTRACTOR State Lic.# z T City Bus.Lic.#(� <br /> Address o{©�-31 0`-Ave- <br /> - VC A)� 1 Q/} yr/ Phone/Email 9- 470 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Ky(t @ CO2,J /4e4 •/lC1 <br /> Phone/E-mail ?j 0 3 <br /> BUILDING PERMIT APPLICATION ICONTRACT PRICE OF WORK /31, -1-'.3- 00 <br /> Existing Use of Building I HEAT SOURCE: <br /> Proposed Use of Building L Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Siign; Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Now„_„Addn ,Alteration_Repair Type of Project: ,,,,,,,,,,Now_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number # of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping T Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> I Gas range Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servicelbar/mo /etc.} 5. <br /> Heat pump Backflow preventer inside bldg) <br /> Unit heater Urinal <br /> i 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 some to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> will wtrethei 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 tical law regulating construction <br /> That I am authorized by the owner of this property to perform the work for hich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Own r/Authoriz d Agent Signaturo Date (Revised 4/2015) <br />