Laserfiche WebLink
� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , [verett, WA 98201 4?5-257-8810 FAX 425-257-8857 wev�,v.everetlwa org <br /> SITEADDRESS: � � / PROVERTYTA%it P�R�"�,a2-o3 <br /> � ,, S <br /> IEGAL lo:ne�.v ccns;n�ctwn�. Snon PiaVsubd�v�son_ Lot No_ (anach eopy ol ieng iegai Cescnphon) <br /> OWNER (�f�7 Q(�/'�� Pncne/E�ma�l yZS 7�Ci G <br /> nao�ess / 7Z�/ � �i, c�y�s�aieiz�� GVv1'v .fJ �/�L7� <br /> APPUCANT:_Owner _O�ne�sngent yCon(ractor _Co�IractoYSAgent TCndnl(mu;ip�c.:oa�rac'ccnsrctton�ncv..�e:mn.enmmosc+ce� <br /> CONTRACTOR /L irt L . Slate L�c. # /,�1�` �`�(ol�5 c��Y e�s ��� A 053 Z <br /> A�tl�ess � �0 Z G/� t// lL �A �D27O P"one�[ma�.l l�Ls J 7SS <br /> TENANT BUSINE55 NAME CO�CT FO�RI PERMIT r� 3G7 7SS� <br /> (a.+y iLo�N,uL/ /L� <br /> Phor.eiGr�ail oi� �! /LSe'JWc•�f.Co <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORN <br /> Ez�sUng Use af BwlC�ng Sf HFr1T SOURCE: <br /> PfOpOSCtl U50 0!BWlding Gas_ Elecinc_ Other_ <br /> �ulldmg rype Single Famdy _Duplex_Townhouse _Mulu�Famlly _Commercial <br /> T e of ro�ect hew Adddion Remotlel Re av T I S� n S nnkler Demohtion Chan e ol Use <br /> DESCRIPTION OF WORK fado.non�i space pro��cea on me oack� <br /> �/-Do� o.�' -h�� l�oru� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typc a�ProJetC _New_Atlan _AlleraGon_Repair Type ol ProjecC _New_AtlJn _Alteralion_Repair <br /> Show Numbcr a ol lirfwes Show Numbcr C)o�fiafures <br /> AIC-au handhn und5 Tatet <br /> Forced ar s�stems DalMub <br /> Gas i in Lavato wash basin) <br /> Water heater Shower <br /> Gas fne IaCe Kr,then vnk 8 drs osal <br /> Gas ran e Dicheiasher <br /> Clolhes d er Clolnes�vasher <br /> Ranqe hood �V�iCt hl'Bll'f <br /> [ahausl lan Sink serncelbar/mop/etc) <br /> Heal um � B�Ckflow fCVCn�er <br /> Unrt hea�er Urmal <br /> I �o�ler Dnnkin PouNain <br /> Relnaeralion Floor dram <br /> Woodslovc Gieasc Irap <br /> Duc6no Roof drams <br /> Other h7etl�cal Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other <br /> Number of Heatls Olhc•. <br /> I nercoy cen��y IM1ai I P��e ma0 an0 cram^•CO I�iS a p4 A1qn ontl know l�e SamC lo Ee WC dn0 CorteGl NI prunLOns ol laws llntl oNmances goveming Inis I�pe ol work will�C ccmpi <br /> wanwnelnerspe d•e re��ornollTa9rammg 1 pem:Adaesnolpresumetogncam�omylonoiaieor�nceunepmv�vonolanymnerstamorlowliawrtgWaimgmmtmn�on <br /> IDai I am amn M me exncr ol ims propc�ty criJrm I�C Ko�k IorwOiti�app':cation Is ma0e anG I Compty w.:7i 1�9 Stala CON2cla6 Law 1B 77 RCW dn4 79B t00A WPC <br /> � J �J�_ <br /> Own /Aut�arizetl Agent Sigwture ' Dale (Rensed 9R014J <br />