Laserfiche WebLink
PERM�T APPLICATION <br /> BUILDING/MECHANICA�./PLUMBING/SIGNISPRINKLER/DEMOL.ITION <br /> CITY OF EVERETT ?�ERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-9810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TA%H PERMIT# <br /> ,Z�1�3 /.,,, Ix,� ,I ,4..� - .�µ �sz.�r � <br /> LEGAL for new conslmction: Short PlaVsubdivision Lot No._ (atlach copy ot long legal descrip�ion) <br /> OWNEFt �Ctlf '�z Gio�l PhonelE-mail Z— z3L 9B <br /> Address Z`p J � C�.i �„��. Cily/SIa�elZip Ev�e.'� W�'.. d Z U� <br /> APPLICANT: Ov¢er _Owner'sAgenl �Coniractor COnl�ac�ofSAgenl _TBnant(mostpmntlealenerotwnsem�mm��eonnerueoworkinmosva:e) <br /> CONTRACTOR /7�� T S f�, I�on State Lic.# NpEI?119�01� City Bus. Lic.# <br /> Address �� �/ . ,Sinp o,n � �/ � /�'rH� ✓�� L��� �ISZ�I PhonelEmail ,3(�p l�'j l -7�iG0 <br /> TENANT 6USINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail /�Cc%-7 3�0 �es � � �S� <br /> BUILDiNG PERMIT RPPLICATION CONiRACT PRICE OF WORK 3�-O� <br /> Exisling Use of Building_ HEAT SOURCE: <br /> Proposed Use of Building Gas__ Eiectnc_ Othsr_ <br /> Building type: �Single Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of project: New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space p�ovidetl on the back): <br /> �,c.5 �,�,�� <<,��� c�4s ��I� <br /> iYIECNANICAL PFRMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TyprofProject: _Naw_Addn _Alturation_Ropalr TypoofProJoct: _New_Addn _Altnration_Ropair <br /> Show Number(N)c/fixtures Show Number(N)o//ixfures <br /> A/C—air handling units I Toilet <br /> � Forced air syslems � Bathtub <br /> Gas piping I Lava�ory(wash basin) <br /> i Water heater I Shower <br /> Gas fireplace I Ki!chen sink 8 disposal <br /> Gas range i Dishwasher <br /> I Clolhes dryer I Clolhes-.vasher <br /> i Range hood I Water heater <br /> I � Gxhaust fan I Sink(servicelbarimopletc.) <br /> � Heat pump <br /> ', E3ack(low preventer <br /> ��I ' Urinal <br /> �i I Unit heater <br /> �� � Boiler I Drinking Founlain <br /> I Refrigeration i Floor drain <br /> Woodstove � Grease irep <br /> i Ducling i Roof drains <br /> i � Other_ j Medical Gzs <br /> SPRINKLER / SUPPRESSION SYSTENI ; other: <br /> i Numberof Heads � Other. <br /> .�,_mby cetlAy thal I have iead and e•amined lh;s opp4cation antl know Ne same to Ce tme and m�rect.All provisions cf Iz�.vs and orCmances goveming this iype ol vmrk wdi be compi�etl <br /> ;.�'h::hetner specified herein or not.The gran�ing ol a pertnit daes not P�esuma lo giva authority to violale or corrtel ihe pmviven ot any otner state or locul la:�regulating conslmaion <br /> Tnat 1 am authorized by Ina owner ol t�is prope�y lo pedom�t�a work br wTich applicalion is matle end I comply with ihe Sla�e Contrancrs La�.v 78 27 ftCW ana 2F5 200A V;AC. <br /> ���J�� �� 3� � <br /> OwnorAuthorizodAgontSlgnaWre � ate (Re��ised3/1013) <br />