Laserfiche WebLink
4W WL 40 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES ,a 0, .402 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> oo <br /> SITE ADQRE + - <br /> p- nn _ ` _ _ ROPERTY TAX# PERMIT# <br /> LEGAL for new construction: Short <br /> CPlat/subdivision Lot No. (attach copy of long legal description) <br /> OWN ERlei lr�� - Phone/E-mail !r- /&44-3 -0%1 _ c G" <br /> Address 21 0 L14 (A 1J60' 'S1, L 1.�G .t( City/State/Zip WA, L?/0z- <br /> APPLICANT:�C 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 State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FORPERMIT L <br /> Phone/E-mail COiE' ��•trCYt.� 'j• 11�/ <br /> BUILDING PERMIT APPLICATION CONTRACT MICEOF WORK <br /> Existing Use of BuildingZY� fHEAT SOURCE: <br /> Proposed Use of Building vf/ t�'�E Gas Electric x Other_ <br /> Building type: _Single Family 1,4 Duplex_Townhouse _Multi-Family )4 Commercial <br /> Type of project: New Addition Remodel X Repair T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTIO OF WORK(additional space provided on the bgckj: G� <br /> URS N 0 U KT r Ali G <br /> :%t Obex <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 /> I Forced air systems Bathtub <br /> Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace ; Kitchen sink&disposal <br /> )( Gas range X Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan ZP Sink(service/bar/mop/etc.) <br /> I Heat pump I Backflow preventer <br /> Unit heater Urinal <br /> Boiler ! Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> f Other I 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 granting 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 am u horiz d by the owner of i 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 /> ZJ/ <br /> r/Authorized AP <br /> ent Signature Dat (Revised 3/2013) <br />