Laserfiche WebLink
ERMIT APPLICATI4 <br />�UILDINGIMECHAI�IGlaLfPLU1VIBING/SIGN/SPRINKLER/DEMC}���1 <br />CITY f3F �V�RETT PERMii SERVICES <br />32CJ0 Cedar St., Everett, WA 98201 425-257-�8'EO FAX 425-257-8$57 www.everettwa.org <br />SITE A�DRESS: PRQPERTY TAX # ERPNI7 # <br />� �.'�- i � r h � 1,r �V t r� �'� '�� `� �'i' 2�aa.3 � � �J � Q � � <br />LEGAL for new constn.chon: �h�rt Plat�subciivisicn Lot Nv.__ (attach copy of long lega) description; <br />CIWNER�-.,n}�;rv,; , � h-;..« �t'r<<41;r- Pnone;E-rnaii ��.�'J'���"����b'�Ga/7lttltc�h6G �/14T:arta,��U <br />AUdress ��.�. �'arfC p' f C!tyiState!Zip �YGt'�-����� �'✓,� �ic�,�.�i.� <br />APPLICANT: Owner Owne�'s Hgent v���Contractor Contractc�r's Ayent Tenant �.,:,;• �>�o���aA :� iA;,:�� <,ru��•ti,n�+�o�,� �r�H ovmF c: �;:�, ���t�.,: >.�,.�,.,� <br />CQNTRACTOR �o /r� r r+� � s'�rn.5 State Lic. #���.7�Sz9a1 P� City Bus. Lic. �--'r> �.� -� <br />Aciuress � �� � 1� � �ve �7 �a4 . ��`� ��-' Phc�ne'Ernail cg�l? "c�(,S�~ � Ot{,�" � 0 4UrG r,�✓s G ��r'r� , �r <br />��.5�`��t`� �'�ta � 11Ct M�' <br />SUILLIING RERMIT APPL.ICATION <br />fVei � C�zo�� 1� r� �'�G-�'G.�wyoac- <br />RhonelE-rrtail 1±�t� W�t:-1� �c�`.��i� �t �� ��a , tc r�r�i <br />Ct'3NiRACT PRICE OF WORK � �''�,a �i��L=? <br />Existir�r� Use of Buiiding S?�.�-. �:aa�;_��€€ _�'�°�°.���� �.__�_.._.___...��..._�.. �� <br />F'rap�s�d Use of Building �� tvti�_� � <br />Buildin� type: � 5ingle Family ._�_ pu�lex �Townhause _ Muiti-Fan�ily ____ Comm�rcial <br />Type of �roject. New i'� Addition Remadel Repair T.I. _ Siqn S�rinkler <br />DESCRIPTION QF WORK (�addiCior�al space providad Ur2 tt�e bc�akj : <br />��s-� II �; G�' k t.��� pv ,�� y.� �:,n �� ��o�. <br />MECHANICAL PERMIT APPLICATION <br />of Project: ,New _Addn _A�teration _Repair <br />Show Number (#) of fixCures <br />A?C — air handiing units <br />� Forced air systems <br />Gas pi��ing <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranqe hood <br />Exhaust fan <br />I-ieat ��ump <br />Unif heater <br />8oiler <br />W nndstove <br />Ducting <br />Other <br />SPRINKLER ! SUPPRESSION SYS7EM <br />Number of Heads <br />HEAT SOURCE: <br />Efectric Oth�r <br />e nf Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New �Addn �Alteration _Repair <br />Show lVumber (#) of fixtures <br />Toilet <br />_ E3athtub <br />Lavatory (wash basin) <br />Shower <br />; Kitchen sink & dispasai <br />Glothes washer <br />Water heater <br />Sink (serviceibarlma tetc.� <br />Backfiaw r�rev�;ni�r tinside <br />Urinal <br />Drinking Fnuntain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medicai Gas <br />Other: <br />Other: <br />I hereby cert�ty tiiat i nave read and exam�red th�s appiicatiar� and know the san�e to De ttue ana correct. AII prows;cns �f laws and orciinances governing this rype o` work •.v:.: ae comF; <br />avdh .vhether specrf:ed 'nerein c>r na! The granting of a perrnit �ees not pr�sume to give autharity to v olate or carcai the provisian of any ��ther state or loc,al law rt=.,u�aur.y consvi,ci.or. <br />T'hst I am authonzed by tne owner of ttus praperty tc perfrurn the work for which applicati�n is mape anc I cornu�Y �vith thcs State Contractors Law 1827 RCW and '296 2C;;,� 4VAC. <br />.�t�.�t � -�� j��G l ;�5' <br />dw lAr Y� Agent Signature Date (f3evised -�/2t)?5} <br />