Laserfiche WebLink
• <br /> PE• <br /> RMIT APPLICATION <br /> UILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL QN <br /> CITY OF EVERETT PERMIT SERVICES <br /> • <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTYTAX ft PE I # <br /> 3I5 C. CAStmo il0 2ScSolDo3o I� olui l� 0 12 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ' <br /> OWNER 54(,tr) if P,- I NO . L-LC Phone/E-mail 4-25.: SS 1 - Lim <br /> Address -1 t Do G06-(2(�C Lo City/State/Zip LcA-4,ctT wii . q 22 3 . <br /> APPLICANT: Owner Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consentfrom the owner to rip work In the space) <br /> CONTRACTOR Ea 5t.6( 2--Nt `�"si-pcT ai'tib' State Lie,# EA -Ie65S0Z2 '( • City I3us, Lie.# 00` 9) • <br /> i' c kJ, n Phone/Email2..:c^ `� U <br /> Address 2��1..� �C.-I�f,� �1 V,� � .r1R��. I,I.T'f� G�e�1 �' 2�2. 0�, <br /> I . . :i 1- 1• r — — CONTACT FOR PERMIT • <br /> WI Irk , ��o,p PA191� l/A-C. �I��'�SSr1 w� .�v N► <br /> Phone/E-mail • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I S,v0 0 R <br /> Existing Use of Building ETAKtL_ HEAT SOURCE: s <br /> Proposed Use of Building ri J Lt{ A' Gas Electric K Other <br /> Building type: Single Family —Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: _New Addition _Remodel Jl Repair . T.l._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> RR 2 RrtU (SpA,c.E 84(1) w I it [Ala F0fi- u kvt v ) 5 (3 e-r cry <br /> (,--Extcia& iitvlc64( . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration 4..Repair Type of Project: _New Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units I Toilet <br /> Forced air systems _ Bathtub <br /> Gas piping _ Lavatory(wash basin). <br /> Water heater ( .Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas rangeDishwasher <br /> Clothes dryer Clothes washer <br /> I Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc,) <br /> 2 Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal 0 <br /> � Boiler . Drinking Fountain . -• <br /> I RefrigerationFloor drain <br /> Woodstove Grease trap <br /> I Ducting I Roof drains ' ' ' <br /> . I Other Medical Gas • <br /> SPRINKLER /SUPPt'f.ESSII,s'NI 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 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 16.27 RCW and 295.200A WAC. <br /> r\VO I (/ g / <br /> EPO Autho •kind Agent Signature D i <br /> (Revised 4/2015) <br />