Laserfiche WebLink
PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />Aoor !CATtnuc ARF ACCFPTF❑ FROM B AM TO 4 PM / ', - '-�—/ Z <br />SITE ADDRESS: <br />PROPERTY TAXI <br />P RMIT# <br />) , D <br />r.( I tN <br />LEGAL for new construction: Short Plal/subdivis on_ _ Lot No._ (attachcopyof long legal description) <br />OWNER j' <br />Phone/E-mail �ib {-• -7' 3556 <br />Address T <br />Gtyislatelzip <br />APPLICANT: _Owner _Oman's Agent _VIGiractor _Contractor's Agent _Tenant lma;r pmwlaa L•nc. ar masrntkom ma oxnar to da worknwe spier <br />AkyrA4tMV <br />LL & I Lic. # 417' COE Bus. Lic. # r [� <br />CONTRACTOR <br />�Ipd13 <br />�vlrtwnn�lilf111ttk4nlul•toly%QD <br />' ` <br />Address D Vj•-t�j y� <br />Phone/Ernail <br />TENANT SINESS NAME <br />BU <br />CONTACT FOR PERMIT l afJc of mow, <br />'I'�C <br />L <br />`T r� <br />E-JJ1tt1Ac-w,&A <br />`� Q/y <br />Phonc'mail JV1%k+•Y 8M1Z7'974A r <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building fad <br />HE T SOURCE: <br />Proposed Use of Building ++-�G(0.� �D I 1 Gas_ _ Electric_ Other__ <br />Building type: _Single Family _Duplex Townhouse _ Mulli•Family Commercial <br />Type or proje L _New _Addition Remodel _Repair _ T.I. _Sign Sprinkler Demolition_ Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): To O�- wot•kt <br />labor �a�l rhater1A1S 4V Coves 4A A.- - u0-p- <br />0.11 �P'C- <br />-Pita% 1Y.o1\q-f . 11 Ptsl di ert�RatAle <br />�tT 10 �S ", syc cs. <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Projocl: _New _Adds XAlteration _Repair <br />Type of Project: _New _Add, _Alteration _Repair <br />Show Number (4) of fixtures <br />Show Number (#) of fixtures <br />A/C- air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />j Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />j <br />Kitchen sink & disposal <br />has range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />j Exhaust fan <br />! Sink (service/bar/mop/etc.) <br />I Heal pump <br />Backnow preventer <br />Unit heater <br />Urinal <br />Boiler <br />I Drinking Fountain <br />- Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />j Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />j Other: <br />I horeby candy that I have read and examined this application and br � the "meta be but, and wooer. All provisions of laws and ordinances governing this type of work wdl be complied <br />with whether speclrred heroin or not. The granting of a permit does nut presume to give authority to vio ato or cancel tho prevision of any other state or local Law regulating construction <br />That I am authonzed by the owner of this property to perform the work for which application Is made and I comply with the Stale Committers Law 19.27 RCW and 296.200A WAC. <br />Owner/Authorized Agent Signature Date <br />(Revised 612012) <br />I'AUA <br />