Laserfiche WebLink
� � <br /> P�:�tVt�T A,PPL��A,�'IOfV <br /> BUILDING/MECHANICAL/i'LUMBING/SIGN/SPRINKLER/DFMOLITIOfV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 w�nnr�.evereriwa.org <br /> SITE ADDRE55: -7 PaOpERTY7Ax a �� <br /> ' / U I � PER�lIT� <br /> i �- I <br /> LEGALfornewconsWclion: ShotlPlaVsubOivision Lo1R'o. <br /> _ (altach wpy ol lang lepal descdption) <br /> OWNER PnonelE-mail <br /> kdtlress c�ryis�memp <br /> APPUCANT:_Owner _O�•mefs Agenl _Conlractar Contraetor's h enl Tenant <br /> 9 Immi pimV o a�c::vi c•mn;eri tvm u�a vn�n=r b m�vary�n e,e sparn� <br /> COUTRACTOR Mve,� I�fc..,�-, h�.� State Lic. #Mocn(��-,f-?l�>'J C� c�iY eo5. ���. �OS 3�5 S <br /> Atlaress 175� 7 y(�`S� � 4L5 7L-� 5-}(,U <br /> >; Srw a�n����. l✓ �� ry�Z�tC) PhonelEmail j��.� c� M�e�I�l,�,���. , cow. <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> P�one/E-ma�l <br /> BUI�DING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exlsl�ng Use of Bmldmg HEAT SOURCE: <br /> Proposetl Use of Bwi'ir,g Ga;__ Elear.c Ctncr <br /> Bw�G�ng type� _Single Family _Duplez_Townhouse _Multi-Famliy _Commerciil <br /> Type o(prory_a. _New _Aatllllon _Remotlel _Repair_.T.I. _ Sign Spncnler Demolition Change o(Use <br /> IJ ES C R I PTI ON OF WOR K(�dd�r�onal spare prov�ded on rnc c�ck): <br /> �nc�l� �'` (�S� k�...�.rJ-�,r �s 1..� rN h�,� ,�„�.� d- Fl��� �...<.t r� <br /> �I ��r �rw{h <br /> MECHANICAL PERMIT AppLICATION PLUMBtNG PERMIT APPLICATION <br /> TypeofProject• _Now�Adtln _Almration_Ropoir TypoolProjeeC _New_Addn _AHoratlon_Rupair <br /> Sho:v Num6ei(q)o/liximes 5how Nambcr(q)of fixrores <br /> A/C-air handling urits � Toilet <br /> I Forcetl air systems j Bathlub <br /> Gas pipiny �����o <br /> I Watzr heater ry(wash basln) __ <br /> Showcr <br /> Gas fi�eplace Kilchen sink 8 disposal <br /> ___ Gasrange � Dishwasher � <br /> � Clnthes d Cf Clothes�vasher <br /> � Rangehootl Waterheater <br /> I Exhau5l fan Sink (scrvico(badmop/efc.) <br /> Heaf ump <br /> Unit heater � BackOow preventer <br /> � urinai <br /> � Boiler Dnnking Founlain <br /> Roingcration � Floor drdin <br /> Woodstove Grease tra <br /> _ i �uclmg Roof drains <br /> —T—���"' Mediwl Gas <br /> SPRINKLER / SUPPRESSION SYSTEM O�her / (,(.L�J <br /> � Numbar of Ho�ds Othe[ <br /> I hemby m�;ly IhM I hnvo matl antl ecmined N�+appb.e�l;on and Mow Na cnmo�o Co Imo unJ m�ct AlI0�N9ona ol law nnC o`E!noncea goveming tMp rype ol�rork w-.:.�ccap'�rtl <br /> N91�qneNcr apeofv_d ne¢in ar noL TTc pmnlNq af o pcnlllt Eoes nol prt:vmc�o gNe a Whotlry lo v:oldta c!Gin[cl0e pmNitan al eny o:her Stlle af IOCBI law regulBl'ny w^.simc�on <br /> Thet I em amhorize0�r Ne or.ner o1 Nls{xoperry io pertortn Ne vm,�k lor��nlrn ap0�!G+"on Is maGe a.�d I ccm;ly x�'h Ihe Slale Con'racicrs laH 1 B27 RCvd enA 296.00A edqC <br /> C/ � ��— <br /> OwnerlAuthoricod Agcnl Signulure Udle �Revised 3n,G 1 JJ <br />