Laserfiche WebLink
! • <br /> PERMIT APPLICATION <br /> BUILllINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., [verett, WA 98201 425-257-8810 FAX 425-257-8857 v✓v,�w.everettwa.org <br /> SITE ADDRE55: PROPERTY TAX p PE T 7 <br /> 3 o g nc�.11'� C� <br /> LEGAL�or nc�,ccn;;iuction� Shon PiaUsubd�visio^ lot Na. (altach copy of Icng Icgal tlescnptron� <br /> OWNER �1.�6�C (t I/� -SnidAD11���1 PnonciE-ma�IT-�(�-l(�p(`l�l�' Q� / <br /> naa«ss � ��g S� JE C�ty/5laleiZ�c SCA9TLL-" < <+ a y <br /> APPUCANT:_Owner ��ner'sAgem Cen!raclor _Contraclor's��gent _Tcnani;m":io�o.me�iorere��.e�ivo�m.o,�eru<��,�:x�.,��.•,,:a� <br /> CONTRACTOR �3tate Lic. N City Bus Lic # <br /> NdO�ess Plmne�Emad <br /> TENANT 9USINESS NAME CONTACT FOR PERMI' „f i1�w � �� - <br /> �� <br /> Phone/E-maa "�G�_UCI—G( Q_7 1 Cn. <br /> - y��.)�t HUL�L � .QIS�A <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK %� <br /> Ezisting Use ot Bwlding HEAT SOURCE� <br /> Proposed Use of Building Gas_ Eiectr�c other <br /> Bu�Id�ng type: _Singte Fam�ly _Du;'ez_Townhouse _Multi�Famity _Commerc�al <br /> Type of pro�ed� New Addition Rerrodel Repair_T.I. _Sian_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(adya�onaispacep�o�medcnrheeack): <br /> A�� ' ti �F l-�� /o � s�Z��, �/ n,,� <br /> ,_ cS w r�i,�_S T-o ,M �Rv1 /' y�—' � <br /> �ac� �v`t ��c�2cr��h �'d '� fi�e�� p�, r� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Projecl: _Now_Atltln _Alleralion_Repair Type ol Projed: _New_Atldn _Alteration_Fepair <br /> Show Number(AJ o/lirfures Show Number(q)01 fix(ures <br /> NG -air handl�ng unds Todet <br /> Forced air syslems Bathtub <br /> Gas piping Lavatory(wash basm) <br /> Water hea�er Shower <br /> Gas fireplace NAchen sink&disposal <br /> Gas range v shwasher <br /> I Clathes dryer Ciomes washer <br /> Rangc hood Wa�er heater <br /> [xhaust fan Smk (,c�vice�badmop/etc� <br /> Heal pump Backflow prevenler <br /> Und heater � Unnal <br /> � �oJer Dnnkmg Fountain <br /> Relrigeralion Floor drain <br /> Woodstove Grease trap <br /> Ducting Roo(drains <br /> � Other � Metlieal Gas <br /> SRRINKLER / SUNPRESSION SYSTEM � Other <br /> Number o(Heads Other. <br /> I hem�y cenAy Ihal I�ave reatl anE examined Ipis appL W I�on ana know t�e same lo be Iruo and wrreC.All provisions ol laws anC orGinances governing Ihis type ol worF wrll he comp'�e� <br /> w�ih wnetner specdi=0�emin or noL Tne grantmg ol a perm�l tloes no�O�esume to give auTorily Io violale or canccl b�e piov�slon ol anY et�er slate or laal law regula'.mg consinc��o� � <br /> 7nat m avtnarizeC 6y i�e ow er of i�is pro0erty ta petlorm t�e work lor w�'¢b app!:calron�s maCe anG I compy wnh I�e Slaie Convacton Lax 18 27 FCW antl 295.100A\tinC I <br /> ��f� ,� /Z <br /> Owncr/Authorized Agenl Signature Date (Rev�sed7�20t3� <br />