Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DENiOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257•8810 FAX 425-257-8657 www.ever`l�a.irg� <br /> SITE ADDRESS: PROPERiY TA%n p�P,N�*« <br /> / 2 c�xf�332 ei oo � .W.I , ;� <br /> LEGAL lor new conslruclion�. Shmt PlaVsubUivislan Lol No. (allach copy ol lang legal desu�ption) <br /> OWNER L.sT� ( G! � � Phone�E�mad <br /> Address � �9� CilylSlatelZip � /J�Y.(XDD �I� 9��{�P <br /> APPUCANT: Owner _OwneisAgent Cantraclor _Conlractar'sAgenl _TenanfU�.+�n�.�eea�snmd�merivomueo.renom.�.M�n�.nesw�ei <br /> CONTRACTOR $upp//� L�o /iJt. Slale Lic.N$�4DFI9L�1�3 G/� Gty Bus Lic.# <br /> AOdiess $210 �A1A eJL4✓E STAW�uz1D Wf� 9b292. Phone/Email QZS.'t?9• 04�1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PAl.+�Y��D <br /> P�onC/E�mml 2$� 2�9� � y�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Bwlding SFR. HEAT SOURCE�. <br /> Proposed Use of Buildmg SFR Gas�C Elednc_ O�he�_ <br /> Buiiding type. X_Sing:e FamJy _Duplex__Tovmhouse __Mulli�Famdy _Commerual <br /> Type of pw�ecl New Addition X Remodel ___Repair _ T I __ .Sign_Spnnkler Demoldion _Change ol Use <br /> DESCRIPTION OF WORK(aad�uonal spaco A�o��ded onlho back). <br /> Co¢RQcy�a�Di2 vto�A�.o,u5 : /Nsr�c.4'7�oi.1� VA✓L7CDG6iuNh F,eo�tfc� RsoF/Al'7, <br /> yr.v►s�d�uE� j EGSc7R�c4� nwoiFi�,q��.Ns <br /> Uewde VE�-�'r' o� �,17K Fs�1 L3"zv 4'`� <br /> MECHANICAL PERMIT APPLICATION PLUM6ING PERMIT APPLICATION <br />� Typa al ProJocl: _Now_Addn YAltaratlon�Repair TyOe of Projecl: _New_Adtln XAltoratlon_Repair <br /> Show Number(a)o/!lxfures Show Num6er(M/o/lirfures <br /> A/C—airhandlin units I Toilet <br /> I Forced air systems <br /> Gas i in Lavato (wash basin) <br /> Water heater Shower <br /> Gas freplace sink 8.9isposa�' d <br /> Gas ran e ( Dishwasher <br /> , r <br /> Q � Water heater <br /> Exhausl lan � Sink(service/badmop/elc.) <br /> Heat pump I Backllow prevenler <br /> � Umt heater I Urinal <br /> � Botler I Dnnking Fountain <br /> I Relri eralion Floordrain <br /> � Woodstove � Grease tra � <br /> Roof drains <br /> � Other _ ; Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I olner <br /> dJ Number of Heads � Other. <br /> I here0y cetlily�hal 1 have iead ond eaamineG Ihm apphcalbn and knaw t�e seme Io Ce tmn anA rorrec� P.II pwvisions ol lawf Bnd ord.+ancef povermnp IMs lypa olworF wip�e complied <br /> wCh w�etllCf iDeCifieO�elem or nol Tne qraniinq al d pem'M1 doM nol D«��me lo grve eNnorAy lo vio'ale or cencel IOe piov�s,Wl oI any clnet slaie or Iw'al law requ�al:ng ronsimclipn <br /> i�al I am aul�orixed Uy I�e owrer ef I�ie propetlY lo pertortn Ne work Por whl<h apDliceliun�s ma�a en0 i compy wnh ihe Stote Cw�mclua law tE 27 RC W an0 79b 200�ri'AC. �/ <br /> /i���✓' ��C �U'�� � <br /> Ownor ulhorizadApontSignaluro D`e (FeviseOYlOI3) <br />