Laserfiche WebLink
-� <br /> /iL.��L f�C.."r•�� �`j � 7C�C - <br /> C � f/ <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRIfVKLER/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 "'� —/ <br /> PROPERTV TAX p PERMIT# <br /> SITEADDRESS: ;� I .! �,: i/ z � 5. ,. .����� y�' j� � -�� <br /> 7 1 �C_ _ ; . R /n ' <br /> LEGAL lor new conslruclion. Short Plat/subdrvision <br /> Lot No_ (attach copy ol long legal descnplion) <br /> J � P�onelE-mail Z� y � �� Z <br /> OWNER ��LUE E� ' �VF��'(T l (,4-/�0 �'��� � . <br /> J�� � ��; (, -. City/State/Lp (,'�}'iT , 1'� <br /> Address �Z,�1 C `�' �� <br /> pPPLICANT:_a++�er QH+iersAgent Con�ractor _ConlractorsAgent _Tenant�m�s+o�•�.knn��'�-'^ypn1ionitl1eOV'""1Oao.���m�•�Q) <br /> CONTRACTOR t�r•";'.. I(cc_l•.k �. C c:i�n.. l �L. L 8 I Lic# :�(, �.� �- COE Bus.Lic.# <br /> � '' �7� Phone/Email �{7.S 5� ,U. `��''� /� <br /> neaess �'-G (�c � t'-1 �; vh1 � 2 w�� S� <br /> CONTACT FOR PERMIT � <br /> TENANT BUSINESS NAME (�[i f'1^<� (� (�� "- �� <br /> (-(��,'��1�'l� I�lJ jli�.ii���l ) >Ci.�.� 1/L`i�! ) PhonelE-mail Q�.(��. �� Il� '� 7SLi <br /> 1i <br /> BUILDING PERMIT APPLICA�TION CONTRACT PRICE OF WORK 3 ��v <br /> HEAT SOURCE: <br /> Exisling Use of Building <br /> Gas_ Electric_ Other <br /> Proposed Use of Building �- <br /> Building type�. _Single Family _Duplex_Townhouse _Multi-Family _Commerci� <br /> Type of projeck _New _Addition _Remodel _Repair X T.I.) Sign_Sprinkler_Demolilion_Change of Use <br /> DESCRIPTION OF WORK lnddinona�sn<«P���ded on�he nack) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProjecL _New_Addnj�Alteralion_Repair TypeolProjecC , New_Addn _Alteration_Repair <br /> iw Numbcr(#)ol�xtures <br /> ShowNumber(p)o�lxturcs � Toilet <br /> A/C-airhendlin unils Balhtub <br /> Forced air s stems <br /> Gas ipin � Lavatory Iwash basin) <br /> Shower <br /> Waler healer Kitchen sink&disposal <br /> ' Gas fireplace Dishwasher <br /> Gas ran e Clothes washer <br /> Clothes d er Waler heater <br /> Ran e hood <br /> Exhausl fan Sink(service/badmopletc.) <br /> � Backflow preventer <br /> Heal um . Urinal <br /> Unit healer <br /> � Drinkin Fountain <br /> Boiler <br /> �� Floor drain <br /> Refri eration Grease Irep <br /> Woodstava <br /> � Roof drains <br /> � Ductin <br /> Medical Gas <br /> Other <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads � Olhec <br /> I hercby ceniy I�e�I heve reaa anJ examinua lhis nppfmalion antl Mnowiho same lo Ee Vue anC curtttt.AY Pmvubns M�eris enU adnances Bovemin8�his lype olxVd vnC�e compGetl <br /> vntti�Niei�er sp��heren or not.lli�BmntnP ol e permn dces nol Pre�umo lo Bive autliwtly lo vulalo or����2 Stale C�onire lors Law 18 27 RC W tl 29fi.Yppp W C��n <br /> l l�:n I nm autl�onzetl�y Ihe ovmer ol lbis property lo peAam Ihe�wrk lar wtiich npG���o^u meEe enA 1 comDN <br /> _ f / <br /> JC <br /> � - �_ ^�`;�/ � <br /> '.- i _ ; ,S� ' (Revised fiQ0i2) <br /> Owncr/Authorized Agent Signalure `� ate <br />