Laserfiche WebLink
( � <br /> . ��� SuPPRE��or1 <br /> PERMIT APPLICATI <br /> BUILDING/MECHANICAL/PLUMBING/SIGN PRINKLE MOLITION <br /> CITY OF EVERETT PERMIT SE //—�// <br /> 3200 Cedar Sl., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERiV TAX M M�T M <br /> �ezi eJea�cEc� wny u zoozo�sao L/ O - <br /> LEGAL lor now conslrucllon: Shorl PlaUsuGdivision Lot No�_ (a��ach copy c'!�ng lega descny:ic:j <br /> OWNER �G—Mo5 DEdGwP��ENT G+.+��'• Ptwne�E-mail <br /> Addross 1076(, $T'''�` d'L.W. City/Slate2ip MkK��TGO � A q$27�'�«�V <br /> CONTRACTOR RT Hco� �' Duct SF.2�ic65 lNG L81Lic.# R�io�b-f��884�— <br /> �•SChncblr@hHun <br /> Address (p10U IZTµ fkVENµE 5 sG•��'�-G W� Phone/Email zUL+•7Zb �OG40 �"��� <br /> TENANT BUSINESS NAME CONTACT FOR PERMR <br /> 2c6•�26 • c940 �,s�1+n<b\y�vt�+ood.coM <br /> N �GK �(Z,. CIZG—STA�t 'LA�1 i� Phone/E-mail <br /> BUILDINGPERMITAPPLICATION CONTruc7PxiCEOFwoRK � 2�'��`�•pO <br /> Existing Use ot Building HEAT SOURCE: <br /> Proposed Use of Bullding Gas_ Eleclric_ Olhar_ <br /> Building lype: _Single Family _Duplex_Townhouse _Multi-Family _Commerciai <br /> Typeofproject: �New _,Addltion _Remodel _Repair_T.I.__Sign_Sprinkier_Demolition_Change ofUse <br /> DeScriplion of Work(addilional space pmvfded on fhe 6ackJ: S�PRE��p� 5�/SrG-�^^ <br /> =n15'���.iuc�taN �,4 P t�yR-ocaE.+n �'{"IDO -F��RE <br /> ItJ'f0 A K�TLHF./� RRNGG Hddp TD �-300 STa�l�.n�a.5 <br /> Have you started working wilhout a permitT _YES ZC NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of Projecf: _New_Addn _Alteratlon_Repair Type ol ProJect: _Naw_Addn _Altentlon_Repair <br /> Sbow Numbar(N)ol flxtures Show Number(�)o!nxtures <br /> A/C—air handling unils Toilet <br /> Forced air s slems Balhtub <br /> Gas i in Lavato (wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> � Clothes d er Clothes washer <br /> � Ran e hood Water healer <br /> � Exhausl fan . Sink(service�barlmo /etcJ <br /> Heal pum Backtlow revenler <br /> Unil healer Urinal <br /> Boiler Drinkln Fountaln <br /> Refri eration Floordraln <br /> Woodsrove Grease tra <br /> - Duc6n Roof drains <br /> p Medical Gas <br /> SPRINKLE I SUPPRESSION SYSTEM Other: <br /> Numberof Heads g Olher: <br /> I herety ceAify that I hava read and examined this applicalion and know Iho same lo bo truo and cortecl.All pro�+isions al laws ond ordinances governing <br /> Ihis type of vrork will ba complied wilh wheth:r specified horein or noi.The granling of a pertnil doos not presume lo give aulhority lo violate ar cancol <br /> Ihe provisioii ol any ather state or local I�w regulalinp conslruction or Iha peAormanca ol conslruction.Thal I am authvrized by Iha ovmer af Ihis propeAy <br /> to parlorm Ihe vrork lor wfiich applicalio�comply with ihe State Conlractors Law 78.27 RCW and 298 200 WAC <br /> lo/5� Zoi t <br /> OwnerlA ri:e gentSipnature Dale (Revised?/20f7) <br /> /� <br />