Laserfiche WebLink
� <br />u <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 />51TE ADDRESS: <br />13, S P4c � {; c �v� <br />LEGAL for new construction: Short PlaUsubdivision /'� q <br />OWNER �d�L� (I! %�*+fP LL C <br />Address jo0 (j��r �3u� C ✓if�'f'�' �✓✓if �jg2G� <br />PROPERTY TAX iJ PERMIT # <br />�° �3 75 72 Go /2t�a d• 0) B/4R �.Z - O�.1 <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail �{ 2,S 33�% i Z3 �% <br />City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent �( Contractor _ Contractor�5 Ag2f1t _ TBf18f1t (must provide a letter of consentfrom the owner to do work in the space) <br />CONTRACTOR SI�t� �"� ��Y'2 $yS74°ji'►f State Lic. # SM-rTHF'S /3�pT City Bus. Lic. # Z3S%% <br />Address ��d6 S�h /7�� L�" "TGCx+rKw W� � fjY'Z�% Phone/Email z53 2'1�Z6S��I J��'1/�l'.++.i{,{�• � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Cu.�� vL �4� r�— Jokr� ��fh� Z53 Lf'8265% <br />Phone/E-mail J Oh�'1►�@S'�' �� hf' /�- ��� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � 3� 7�`S <br />� <br />Existing Use of Building Y'^ � KL"� hse i m4"G�`n �'�'Q HEAT SOURCE: <br />Proposed Use of Building ✓'`� K�l/� aIG-, I�"'��ti)�����b'� � Gas Eiectric Other <br />Building type: _ Single Family _ Duplex _Townhouse � Multi-Family � Commercial <br />T e of ro�ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back) :�� �� S�� i.Z Klef� b2 (Otn/ <br />/�e_�..� {£.�� Ce r` L � ti-9S <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />A/C — air handling units <br />Forced air svstems <br />Gas piping <br />Water heate <br />Gas fireplac <br />Gas range <br />Clothes dryE <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />�7 Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatorv (wash basin) <br />Kitchen sink & disposal <br />Dishwasher <br />Water heater <br />Sink (service/bar/� <br />Backflow preventf <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Roof drains <br />Medical Gas <br />Other: <br />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 compl <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision oi any other state or local law regulating construction <br />That 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 />�� � 3' 27 /5 <br />Ow er/Authorized Agent Signature Date (Revised 9/2014) <br />