Laserfiche WebLink
PERMIT APPUC ATION <br /> BUIL,®ING/Vi EC HAN ICALIP LU M BIND/SIGN/SP RINKLERMEM 0LIT1®N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wvvw.evereftwa.org <br /> SITE ADDRESSI PROPERTYTAXtt P IT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of ibng legal description) <br /> OWNER �pY�p Iµap1tA�t_ Phone/E-mail 1425--Z38- <br /> Address <br /> 425-23S-Address '30O goAt AUC <br /> City/State/Zip TGVGIIZf['f WA Q8Z0� <br /> APPLICANT:_Owner _Owner's Agent �c—Contractor —Contractor's Agent _Tenant(mus(provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR FVC 6-,'PC1=-tA --jTAE66 '5&Z114nX- State Lic,# vEI&55C?2_ZE'l City sus, Lic.# OG'71155 <br /> Address 2k-2-0 I~J . W'A qq D( Phone/Email TZj 2-s?- I,, U <br /> ,IrTENANTCONTACCONTACT F��QR PERMIT <br /> NDrco N1a10��( MAgk&f_55M0A•Cvr^ <br /> Phone/E-mail IK*Nr m"►- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK R.g4Y <br /> Existing Use of Building Of*" -blo HEAT SOURCE: <br /> Proposed Use of Building t4O Cborrs Gases Electric—other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family -�Commercial <br /> Type of project: _New _Addition —Remodel Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> -ZEWLA;r i�f A-L-b L)a-)'Ti ti QTS c't}f g+� �✓� Cpp X <br /> MECHANICAL PERMIT APPLICATION PLUMBING;PERMIT APPLICATION <br /> Type of Project: _New_Addn _AlterationRepair 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 air systems 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 I Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains ' <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSIOM 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 /> Thatthorized by the owner of this property to perform the work for which application is made and I comply with the State contractors Law 16.27 ROW and 296.200A WAC. <br /> 6yffleni/authorize Ag t Signature Date (Revised 4/2015) <br />