Laserfiche WebLink
w•�•+1 II�7�IJI;� <br /> • r11 � <br /> �ERMIT APPLICATIO� <br /> BIJILDINGlMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLI�'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 42�257-881L� FAX 425-257-8857 �+nvw.everettwa.org <br /> SITEADDRESS: �/� / PqOPEqPTA%p P RMIT# a�'7 <br /> OGv�rP VE� C S� O� 'J� `�o-Z S —Q/C� <br /> LEGAL for nevi censtmclion Short PiaVsuCdN�sion See q� O C\.P� Lot No \�r� (atlacn copy el long le.gal tlesa�phnn) <br /> OWNER a/e�r Go !<.�A /r1P/�///J GLi Pbone/E-mdil SJ'9'�'.���1 f�o0 (�r0l�w.�o 2 �c��7N /.�rK, (�T" <br /> Ad:ic",s 3 �J s� Z� C/'/� �. ?� '� CrtylSlatc�Zip <br /> �I'PS7`o.7 /�ri 7 <br /> APPLICANT: �Q+mr _Ov:ner'sagent _Coniracicr _�onlra:!ofsAgeM _Tenant�T„nc�o.aoo�n���imo•.nwcm�eow.�,:,ioc,..on �,n,,,:;;��,��. <br /> CONTRACTOR�i�St �'i� :S� ' :o/I St l�% State Lic # � '�. �� �G�?, C�I Cdy Bus. Uc tt��''SrJ�j <br /> nadmss ✓C G1S (/�-� "n i • �/0/l JCC� 'L�/- �W1Pnone�Emad j�✓ -�'L' O -L' J� � <br /> TENANT BUSINESS NAME CONTACT FOR PERM�T <br /> ;�('o G c�r G o r/u�,'�7 (� <br /> Fhene;e�ma�l �'f — G,����j0� <br /> BUILDING PERMIT APPlICATION CONiRACT PRICE oF WORK <br /> ExisUng Use of Bu�itling_ _ HEAT SOURCE <br /> Proposed Use o!8uildln9 Gas eiecmc omer <br /> 8uilding type�. _Single Famtly __Duplex_Townhouse _Multi�Famtly _Commercial <br /> fv e of ro�ecl New Adtlition Remodel Re air T I ;,i n S rinkler Demolilion Chan e of Use <br /> DESCRIPTION OF WORK luad:nona'spacc prov�ae�on tne back) <br /> Dr.��,�likto�� �'�r �����- �`c:r dc-rno��ktot� c� �tii �1 �rC., Gat»:�e_. <br /> MECHANICAL PERMiT APPL�CATION PLUMBING PERMIT APPLICATION <br /> TypeofProjed: __New_l�ddn _Alteralion_Rcpair TypeofPrqeet: _New_Addn _Alteralinn_Rcpai� <br /> ShowNurn6c� 71 ol/iHums ShawNamDc� q ollirfums <br /> A!C —air handlin unds � Toilel <br /> Forcetlairs stems Balhtub <br /> ' Gas i in Lavato wash basin <br /> Water heai^r Shower <br /> Gas lire lace � Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> I Clolhes tl er Clolhes washer <br /> Ran liootl � Waler heater <br /> Exha�st lan Sink servicelbarlmo letc <br /> Heat um � Backllow reventer <br /> Unit heater � Unnal <br /> 8oder Drinkm Fountain <br /> Refn eration Floor drain <br /> Woodstove Grease tra <br /> Oucim Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other <br /> Number of Heads � Other. <br /> I hereEp ceN!y Nat I liive icaa anE eram�neE Ihis uDG����n anG know tAe same lo Oe We ana cer;r:d An p;ovrs�ons ol laws-�C ordmances govem�ng In!s hpe olwork w�i b�wmp'�. <br /> H:NwhelherspecdcA�ereinornol Thegranhnpolape�m't0oesnolprevime�opneaW�oiEyiovn•a!eo�canu.Il�epmv5�onolanyolherstaleoilocallmvreguL�6ngmnsW<Inn <br /> IDal i am aui�or�zea�y Te owner ol this D�opeM�o perto�m Ue�inM�or whcn appEcation is maCe antl i wmpry wM tho SRre Centrdcrors Lavi t B'.7 RCW una 296 200A WAC <br /> ��-� .���'�c�; /2-/7- i�I • <br /> OwnedAu�honzed 0.genl Signatwe Date �- � (Revised 9.�2014) <br /> �e ..w <br /> ' ..a, w,r+r���f ` a�+ <br /> d�Y�l, <br /> `.raaq�t � - �;ys.. <br /> yu�� <br /> hmw,n <br /> �u."""•• . <br />