Laserfiche WebLink
t <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT <br /> 32-10 3(, 0 iAlgce A E-✓c(evJ./a 2 1brjG�S��G>yf�OZbI ') <br /> LEGAL for new construction:(Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Co,gc fie_ O( `Ltle ti Phone/E-mail �Ct9, 7�U, (�`/�1 ,AC r c b, 1't S. to, <br /> Address l C) 600� City/State/Zip pill t,u sN 1 V t; 0"t <br /> APPLICANT: 4 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 G��v:�ri� State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESSNAME ���✓�� _ CONTACT FOR PERMIT' c:•,7 C,X <br /> //,, <br /> C"A"'L+-e '"�-SCJ -770, Cly 1L� <br /> Phone/E-mail of p V►C' c,✓c? %FS Co.N1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK If Z4.& <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 ofproject: New Addition Remodel Re air T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): P�ac<.�7r>T oto la j2'�S�;/' �4c �'c ,4Vii;le <br /> -fv be rA seilit' ca.S t� �:1✓Q��5 /hC'e J�7 f` r✓C i�'1. �,!i f t.� /� X119 t cx fPsl`'%DO/�`L <br /> j6wi cv./l ke I01.�hbe� t-v t-I*- OA,' i-' 5 �i✓:1, �o%C�!"nf f r../� --/1�.rhR�rr�r» �� ���Ci`/e <br /> G2y�is� ,Q:tfJ�r'�r/ Sytk••, C��el�-y- /'«r,�t�e�/ �t.,�l- /aKdrtir � I� .�2oe�'7c��27o6&S � a�� w'�!� <br /> c��,nnrti c�x si: f1i Public L,)44-OC, -771e w;// rat he opll 4,, +,tt IA,0tC- - <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 airs stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc. <br /> Heat pump Backflow preventer(inside bldg) <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: I �rsl�� l <br /> Number of Heads Other: (c J ( ) G <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 slate or local law regulating construction <br /> at 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 Law 18.27 RCW and 296.200A WAC. <br /> 2 �5 1 <br /> Owner Authorized Agent Signature to (Revised 4/2015 <br /> [y, y <br />