Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.or / <br /> APPLICATIONS ARE ACCEPTED FROM 8 MM TO 4 PM J '��� — � <br /> 51Tr EADDRESS: n PROPENTYTAXp PE IT# ' <br /> k/'� Z� �'l,l L�1c.�'C /i v <br /> LEGAL lor new construclion: Short Platlsubdivision Lot No.,_ (altach copy of long legal descnption) <br /> OWNER GV�O `!-��'�h ZU6-3eS-y//1 phonelE-mail �7JIiN C • �. � ✓�'� <br /> � ,�- U� ' � f C�rylStatelZip C V�' 1��� �✓�� / �Z o� <br /> Address rL5 i �CC U7� L V2 C'l1 <br /> . <br /> qpPLICANT:_Owner _OwneYSAgent CoNractor _Conlractor'sAgent _Tenantl��:ip�o.weak�a�o!�o�amo-orr..o-..*�raeowon��oma�c.�t <br /> CONTRACTOR !� C 1'i u� S�'tiv I C � L 8 I Lic.# COE Bus.Lic.# <br /> �i � ti TZU� <br /> Adtlress 2.0 NY /S Z �J ��¢.h b✓f yg 8 Phone/Email , 'ti W la..i � • i � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �-�� : � Z�- (/g 7_ ��c�� <br /> P�one/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 'db <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eieclric_ Other_ <br /> Building type: �Single Family _Duplex_Tmvahouse _MWU-Family _Commercial <br /> Type of pro'ect: _New Addition Remodel Repair T.I. Sign Sprinkler Demolition Chanqe of Use <br /> DESCRIPTION OF WORK(addi�ional space provided on tne back); <br /> � <br /> ��I,��,c ���� Oi � -��r�ic.�t v� '�� '�'G�J �rn�:c-c <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> iypoofProjecl: _New_Addn _Alturallon_Repair TypeolProJect: _New_Addn _Alteration_Repalr <br /> Show Number(bJ ol fixtures Show Num6er(M)of flxtures <br /> A�C-air handling units Toilet <br /> Porced air s stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhausl fan Sink(serviceh admop/etcJ <br /> Heat pump Back(low preve.iler <br /> Unit healer Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Olher: <br /> Number of Heads Olher: <br /> I Iwir7/cetlAy Nat I huve read and eaam�neJ��is aFVlKation antl knaw No sama lo�a W e nntl corted.M prorisiom ol lawf nnE ardnenem Bovemin0 Nu type of work�hA Oo wmpfed <br /> v.en e.het�er speGfied Oerein or nol.Tba granlinB af�pem�il dom not pmsumo to phv ouNOMy Io Nolale or eancel lhe provisbn ol ony olher slale or loeal law repulalh0�a�slm<lion <br /> lhay I am auNodmO Ey��e owner oi I�b propeM�o Pe�ortn I�e work Iorw�K�oppkaCan b matle and I compy wt�Ne State ConVaclom law 10.P7 RC W an0 298.200A WAC. <br /> ������ �,�,� � . �c-�� � �/��lz��� <br /> Owner/Authorixed Agent Slgnature Dalo (Rerisetl�201T) <br />