Laserfiche WebLink
PERMIT APPLICATIOf� <br /> BUILDINGIMECNANICALIFLUMBING/SIGN/SPRINKLERIDEMOLfTION <br /> CITY OF EVERETT PERMIT SE��VICES <br /> 3200 Cedar St., Everett, WA �J8201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERNTAXH PERMIT _ <br /> SITEADDRESS: �j - (j � � <br /> /n. i f �vEru��c�✓ W <br /> LEGAL for new construclion: Short PlaUsubdivision Lol No._ (atlach copy ol long lec�al description) <br /> OWNER'Ti'i�r�t.��a-iC p�'i°��-r'� Phanc/E-mail 253 ' 3 - 1 h 3 <br /> Address t/o b ELL��/4 �r/.� /ZD Cily/State/Zip ,(�p c rH e W�� 4 Ya'`I7 <br /> APPLICANT:_Owner OwnefsAgenl Conlractor _Coniractor'sAgent _Tenanlem�siv�^n000ier,ero�ro�s�mrrcmu�.00Hrer:oao+o«������sv�:�1 <br /> CONTRACTOR � L (s��U%Q� � S' Ct,�S' L 8 1 Lic.# ! `7 C/fi� COE Bus.Lic.# <br /> Address o 6/6 r Sritvc. 5 �FFu �� /��6� PhonelEmail 2ti'"6 '- Z�'— �'� d <br /> TENANT BUSINESS NAME CONTACT FOR P RMIT <br /> J u I ia�..! �t-a,ua�l <br /> oFi�rGE A ��a� PhonelE-mail hG�t- 23'�'7��7 <br /> BUILDING PERMIT APPLICATIOFi CONTRACT PRICe oF WORK ���� � � �� <br /> HEATSOURCE: <br /> Existing Use of Building <br /> Gas Elec�nc_ Other_ <br /> Proposed Use o(�uilding — <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project_New _Addition _Remodel `Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> DESCRIPTIONOFWORfK(additionalspaceprovide,d.(_o�ntheback�: ` <br /> � N���r-� � �G��t«� �� L--I c.J�F�L S\`� � <br /> fNECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _New_Addn _Altorallon_Ropalr Typo of ProJecl� Sho v Number(#)o//ixtu`res`ion_Ropair <br /> Show Numbcr(q)ol lixfures <br /> A/C-air handling units : Toilet <br /> � Forced air systems I BathWb <br /> � Gas piping Lavatory(wash basin) <br /> Waler heater i Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gasrange i Dishwasher <br /> � Clothes dryer I Clothes washer <br /> Range hood I Water heater <br /> Exhaust fan I Sink (service/b2dmop/elc.) <br /> Heat pump ( Back(low preventer <br /> Unit heater I Urinal <br /> Boiler I Diinkir�g Fountain <br /> j Refrigeration I Floor drein <br /> Woodslove I Grease trap <br /> � Ducting i Roof drains <br /> � Other_ � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> � Number of Heads ��I Other: <br /> I h^ieby cetldy Ihat I have read and examined Ihis appiica;ion and knoa�ho same lo be Imo antl correct.All pmvisions ol laws antl ordinances governing Ihis type oi wa�k�nll 6a compli:C <br /> v;dh v:ne�her speci/ied herein or not.The granling ol a permll tloes nol presumo to give aut�ority to violale or cancel the pmvision of any other statn or lowl law iegulating construction <br /> 7hat I am aNhorized by the owner of this propeny to pedortn the Nork lor�vhich upPlication Is made anC I comply wdh�he Slnte ConLaclors Lew 18 27 ftCW and 796100A WAC. <br /> �� `/Z <br /> ��6��z_ <br /> 9 �� (Revised 62012� <br /> Ownor Autho iz J A�ent Slgnaturo <br />