Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIM�CHANICAL/PLUMBING/SIGN/SPRINKLER!DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vrr✓w.everettwa.org <br /> �I, , PROPERNTAXN PE MIT�O ' <br /> SITEADDRESS: �,ffOZ LQM13/}'(� �Tv� <br /> LEGAL fo�new conslruc�ion: Shorl PlaVsubdivisian lot No._ (auach copy of long legal description) <br /> OWNER kJC.( ��L�- PhenelE-mail Z�C –��—� ��� <br /> Adtlress ��V2 wNtB/17�✓ �� City151a�elZip ��1,.7eu� �^/� y�� � <br /> APPLICANT:�Ovmer Owner'sP.�enl CoNracloc _Contractor'sAgen! _Tenanl�rr.�sicmheoaieueroim�se�nrommaownenoaowoa�n�nospa:�1 <br /> CONTRACTOR SFL� D�lY1� Slale Lic.# City Bus. Lic. # <br /> Phonelcmail <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhoneiEmail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> 1 <br /> HEATSOURCE: <br /> Existing Use of Building <br /> Gas Eleclric_ Other_ <br /> proposed Use of Building — <br /> Building type: �Single Family _�uplex_Townhouse _Multi-Family _Commercial <br /> Type of project New _Addition �Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(avddional space provided on the backl� <br /> 1'���,��l.lC� ��1�(;U7. <br /> MECHANICAL PEFtMIT APPLICATION PLUMBING �ERMIT APF'LICATION <br /> Typo of ProJoct: _Now_Addn _Alteralion_Ropair Typo of ProJc��� ShowlJ�mbcrd(#)o//ixtutres�ion_,Repair <br /> ShowNumber(#)of��xtures � Toile� <br /> � A/C–air handling units I <br /> � Forced air systems Bathtub <br /> i Gas piping i Lavalory (wash basin) <br /> Water heater � Shower <br />^� � j Kitchen sink&disposal <br /> Gas freplace <br /> I j Gas renge i Dishwasher <br /> I Clolhes dryer Cbthes washer <br /> ' f ; Ranye hood �ti Waler heater <br /> � � Exhaust fan Sink(servicelbadmop/etc.) <br /> I ' Heat pump Backflow preventer <br /> � Urinal <br /> ',,I � I Unit hea�er � Drinking Fountain <br /> ! Boiler <br /> �; � I, Floor drain <br /> +I = ', Refrigeration i Greaselrap <br /> ; Woodsiove <br /> Ducting I Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTENi Other: <br /> �i Number of Heads Other: <br /> !._reby<eMity I�at I have re�d and examined this application and know I�e same lo be ime antl ccrmd.All pwvis�ons ol la�,vs and ordinances governing ihis ryFe of work will be cemF^�etl <br /> e:h wM1ether speci/iea herein or noL The granling ol a pertnil tloes not O�esuma in give au'ncmy to v�o'ate or cancel Ine provrsicn cl any ciner stale or b:al law re9Waling conslruGicn <br /> llial I am authorizetl by the ownef o/l�is property to peAorm Ihe�mrY./of whicn applicaimn is m,.:e antl I compty�:i1h��e Sla:e CONraclors Ww 18 27 RCVJ anE 296 200A VJHC. <br /> �'�(��C(� ��_ C"��l(-3 (Revised3/2073) <br /> Owncr/A V narizeJ Agent Signaturo Dale <br />