Laserfiche WebLink
B/13/11 09 : 58PM PDT '8666104883 ' -> 14252578857 Pg Z�3 <br /> PERMIT APPLICATIQN <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810 - FAX 425-257-8857-wv�nv.everetlwa.orc� <br /> APPLICATIONS ARE ACCE?TED FROM 8 AM TO 4 PM <br /> SITEAGDRESS: PE T#' <br /> 2323 Lombard Ave PA�'�`���149401200 • , - <br /> LEGAI for newconsfmction� Short PIaV,ubdivision Lot No._ I���ech copy of long legal desuiption) <br /> OWNER Micke Pave Phone/E-mail <br /> Address Om ar UPi City/51ale/Zip Everett WA <br /> CONTRACTOR Belfor USA Grou LEILic.# BELFOUG990BJ <br /> naa�ess 4320 S 131st PI, Ste 100 Seattle 98168 Phone/Email 206-321-6559 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> P�one/E-mail curt.knutsen@us.belfor.com <br /> BUILDING PERMIT APPLICATION coNTRAc7 PRicE oF WORK $7500.00 <br /> Exis[ing Use of Building Residence HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eiectnc x o�ner_ <br /> Buildingrype: �SingleFamily _Duplex_Townhouse _MWti-Famiry _Commercial <br /> Type of project: _New _Atldition _Remodel X Repair__T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DrsCfiption of Wofk(a<klitbnal syceprovided on tho backl: <br /> Repair or repiace as required damaged freming, roofing, siding, dry�vali from fire. Affected areas <br /> laundry room, kitchen and deck. Repairs/Replacement with like kind and quality compliant materiais <br /> Have you startetl working wilhout a p���»u� _ves _No opened for fire and electrical inves6gation/inspection <br /> MECHANICAL PERMIT APPLICATIC�N PLUMBING PERMIT APPLICATION <br /> 7ypa of Projact: _New_Addn _Alteration_Rapair Typa o!Prolect: _Now_Addn _Alteration_Rapair <br /> Show Numbcr(iq oI1/rtures Show Number(�ol/lzlures <br /> A/C—zir hanClin units Toile[ <br /> � Forced air s stems �i Bathtub <br /> Gas qi in i Lavator (wash basin <br /> Water heater Shower <br /> 'I Gas fireplace Kitchen sink&disposal <br /> � Gasran.e Dlshwasher <br /> � Cbthes d er ''�, Clothes washer <br /> � Ran e hood ! Waler healer <br /> Exhaustfan Sink(servicelbadmo /etc. <br /> ^` � � Heat ump Backflow preventer <br /> � Unit heater Urinal <br /> I Boiler Drinkin Fountam <br /> � i Refriqeratirn Floordrain <br /> ' Wootlstove Grease trap <br /> Duciinq Roof drains <br /> ' Other ''� Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> � NumberofHeads Other <br /> I here�y ceAily Ihat I have read and esamined this appliwtion and know the same l0 6e We antl cortect.All provisicns of laws and adinances govemin9 <br /> this lype ol wak vAll 6e complied vnlh vficlher spedfed herein or noL The granlin9 0!a permit does nol presume lo give aulhority lo violat�or cancel <br /> the pro�ision of any other state or Iocai luviregulating conslruction or Ihe pertormance of consirudion.That I am autho�izetl 6y Ihe ovnier of ihis property <br /> to pertorm Ihe work(�� dLau .ationi.�n.ade and I compty with the State Contractwe Law 18.?7 RCW and 2962W WAC <br /> �-'"��� 9/13/11 <br /> O:vncrlAWhorimd Apanl Siflnoluro Date (Reviscrl:J_'0171 <br />