Laserfiche WebLink
PERMIT AP�LICQ TiON <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLERlDEMOLITIOfd <br /> CITY OF EVEF;ETT PERMIT SERViCES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 F=AX 425-257-8857 www.everettwaarg I � <br /> APPLICATIONS ARE ACCEFTED FROM B A'JI TO 4 PM � � <br /> SITE ADDRESS: 1 �/� PROPERT(TAX H PERMIT# 5 <br /> � +�"r .'�C�"v1 �r�!'C]- til IJ� <br /> LEGAL for new consiruction: Short PlaVsubdivision Lo1 No.,_ (at�ach copy ol long legal description� <br /> c � 'rt �(,9iaY��'1 Phone/E-mail <br /> OWN�R I�i � � L•.� 6 � r���-� — <br /> Address �3 ,� �( ' Lovv� �r�-d. /�v-'� City/SlatelZip L� e re� u�J�l• ��-Z ol <br /> APPLICANT:_Owner OwnersAgent l�oNractor Conlraclor'sAgent _Tenanllm�si�ronee�ien�ror�o�s�mo-ommec«r,ermaawcrxmmaspa:el <br /> CONTRACTOR l r a C�. CoY> '�/'u cT7 o�q �1c. L&I Lic.# �C 1 EC ZL3/ C� COE Bus. Lic. # <br /> Address �.f�. �iv ' �/�%% (�-'vr%diio� i/�e . W1� �'�S�'l� PhonelEmail <br /> TENANT dUSINESS NAME CONTACT FOR PERMIT <br /> ��f' �`�'-l� �� �1�P <br /> Phone/E-mail �' �._� �� �3 — �%�r�( <br /> BUILDING PERMIT APPLICATI4N CONTRACT PRICE OF WORK'� S �S R'9a <br /> . �� HEAT SOURCE: <br /> Existing Use of Duilding � �� " � <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: _Single family _Duplex_Townhouse _Muiti-Family '�CommPrcial �I�u�l <br /> Type of project: New __Addition ,_Remodel _Repair_T.I._Sign_Sprinkler_Demo�. �i_Change of Use <br /> DESCRIPTIONOFWORK(aaditionalspaceprovidedontheback): (� , �� ��- �:'� ri�5 ���(� � ��' �'"`'°'d <br /> 1 C VY7 L V� i-� • f� f / <br /> �� �IPr''l�irl� c-v1 '><-v-�� `; � c�� r, ��a��� 6�)c'cv cc_� ry:�> C:i7/O.i l��CJ` <br /> f`� ._, �'O�[AC"1�1 ��c: G_'� C.t-.l.� '(��; �c'. L`��'>f�_.. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLSCATION <br /> Type oi ProJecU _New_Addn _Alterallon_Ropair Typt of Project: _Now_Addn _Alieretlon_Rapair <br /> Shaw Num6er(p)o//ixfares Show Numbcr(N)o(fixfures <br /> A/C—air handling units ' Toilet <br /> , Forced air systems ' BathWb <br /> \I Gas piping �, L2valory (wash basin) <br /> i�� Water hecler I Shower <br /> � '� Gas freplace Kitchen sink&disposal <br /> � `, Gas ran�e 'i\ Dishwasner <br /> � Clo;hes dryer I � Ciolhes v+asher <br /> r � Range hood i Water heater <br /> F � Exhausl fan _ 'nk(service/badmop/elcJ <br /> � Heat pump I Ba�kFlow preventer <br /> I Unit heater I Urin <br /> r-- Boiler � Drinkin Founlain <br /> i� � Fluor dr�in <br /> � Refrigeralion <br /> �-"- � Woodstove � Grease treb <br /> - Ductmg i Roof drains \ <br /> � Other i Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Othec <br /> 1� Number of Heads � Other: <br /> I here6y ce�Ay that I have read and examined Ihis appl�cation anC knorv Ihe same to be W e and rnrrec�.All pmvisions ef laws and ortl��nances goveming Ihls rype ol work will be comp4ed <br /> with whet�er specifed heieln ar not.The granting ol a permit does not presumo to give aut�oriry m v�o!ate er car.cel tne provison of any oNer state cr Iccal iaw regulaling wns;mn��on <br /> That I am eu�orize0 by I�a owner ol tnis property to pedorm Ihe work 1or xTich app!ication is m�tle antl I mmpry w'.�Ihe S�a;e Contracfois La�i 18.27 ftCV!and 2E6 20�A 41'AC. <br /> �,�;� .a.�,�� ���1;{Sy__ �S =2��'� <br /> (Revised 62072) <br /> Own^dAuthorimA Agent SignaW r6.! Da�n <br />