Laserfiche WebLink
07/05/2p16 TUE 8:2a FAx Fa�t water xeater �003/003 <br />� �ERM�1T A,P�'�.ICA1"�� � �I l ... <br />BUILDIIVG/IVIECI-IANICAL./PLUIIAE�ING/S(GN/SPRINKL�R/pEMOLITI�IV <br />CITY OF EVERETT PERM17 SERVICES <br />3200 Cedar St., �vereifi, WA 95201 425-257'-8810 FAX 425-257�6857 www.everettwa.org <br />ITE ADDRESS: <br />-- - �1 �a s ��E � � <br />�GAL Poi' n9W car�structlon: Short Platlsubdlvle <br />OWNER <br />L <br />Address � �' � � '� <br />APPLICANT: � p�e� _ Owner's Agont � Contractor <br />CdNTRACTOR � �' �f�}-f-�� �-I�.-� <br />Addrees i ��4�, F�1 1.��.�1— `i"��/U��S�� <br />TElVANT BUS1N 5 N�AME ' <br />� <br />BUILDING PERMI'1' APPLIGAT�ON <br />Existing Use of Bulldln��� <br />Proposed Use af c� �� <br />Building type: 5ingle Famlly !]upleH _� <br />P�RN[iT,# ,;-� <br />Lot No.__._ (attpCh Copy oF long legel d�sCrlptlon) <br />Phone/E-mefl �� �' l � �I � � <br />���y,s�t�,z►a �U r,�. 9 �� � <br />CO�tfactoT'S AB�nt _ Tenen! {must provWe e �etter af coneenl fram �ne ewnor to dv wvnc �n uie avece) <br />State Lic. # - W 1J�f g Ity Bue. Lic. <br />�� J� ^n� <br />(P_Pf Iill�'/.�• PhonelEnldll "7r��rd �(n�.�J /�Pv✓1� rf--�,� C1-r, <br />�'�� ��NrL�. <br />Phone/E-mall L <br />CON7RAC'� PRICE OF WOFtK U <br />HEAT SOURC�: <br />Gas Electrlc Oth�r <br />Mulli-�amily _ Commarcial <br />i T.I. 5i n S rinkler DemolftEon . Chanae n� <br />DESCRIPTipN OF WORK (addltlon�� space provlded on tP�e aokJ : <br />��e� �,�.� Ic� � S <br />� <br />MECHANICAL, pERlV�t'1' 4,PPLlCATIaN pL 1V <br />�ypa vf ProJect: �,Naw _Addn _Afteratfon �Rapalr Type of ProJa :�Naw <br />Show Nur�bel # oPflxturas Show Nu <br />A/G � alr handlin units <br />Forcad afr s stems <br />G9s i In <br />Water heat�� <br />Ga& flreplace <br />es <br />uet fan <br />n <br />1 +A <br />Use <br />G PERMIT APP4ICATION <br />�ddn _Alleration _Repalr /` <br />Tol1 <br />gatht <br />Lavato wash t <br />Showar <br />Kltchen sink <br />Dlshwashel <br />Cfothes sher <br />Weter �ater <br />Sin servicelbar� <br />B kflow rmvent <br />i�inoi , <br />� <br />Ductin ' � Roof dralne <br />Other Medlcal Gas <br />SPRINK PR STEM Other: <br />mbar of Hea Other: <br />I hel'mby oeniFy thet I have re&d and exgmineU thls eppllceiian antl Know Ihe Beme to ba trua and correcc_ qll proVfslona of lew0 arld orciinahcea governing thle rype o} work will 6e comp <br />wllh whether speclfletl her��R or not. The y�anllnp oF e permlt tlo�s nvt presume �p g�v0 duihority to vlo�clte or canae! the prpv��lon oF any afher etet9 or lOtal law �gulallnp conalruolfon <br />The�l I em authadZea ny She awner of thl� proverly ia peAoi'++� Rhm worlc Par whlcn �ppflCmNon le motlp �ntl I Gomply wlth lha Slale Contrectara Lsw 1g-27 RCW and 286.200A WAC. <br />Own Avthvrized Agant 91qnAture Oate �� <br />(Revlsed Q/2095J <br />