Laserfiche WebLink
� � <br /> PERMIT ARPLICATION <br /> BUILDINGIII�IECHANICAL/PLUMEiINGISIGNISPRINKLER/DEMOLITION <br /> CIN OF EVERETT PERMIT �ERVICES <br /> 3200 Cedar SL, Everetl, WA 98201 425-257-8870 FAX 425-257-8857 w�vw.everettwa.om <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRES,s' PROPERTY TAX k PER i IT pO — OO <br /> b �AC�SCI\ �' 00$'SfS/D H - O -00 � W <br /> LEGAL Icr new co�SWction Short PlaVsub,livis:on Lot No_ (attaU coDY o�long legal descnpLon) <br /> OWNER v� Tf,Q'(� IM Pnon�E�ma�l'1�2.q�—Z�{2.9 ,CTe��'1Q�11Y���tlf4'liC' <br /> Aadressi .` p� � (�Ve . /Ul'. Ciry/SLteJZiP � SV11� �D � Ld <br /> APPLICANT:�Owner Owne�sAgent �Contractor ContracrorsA9r.nt ienant�m�s�omnaeaiersrmw�semvommaw.,vioaowMmmew�w� <br /> CONTRACTOR W� �e f� �Y�'�e L 8 I Lic N���S�O I ZD ZCOE Bus. Lic # <br /> AEtlress �, � 1�.�1 a�,}� • �v � PnoneJEmail 'oel�hqack���,ers�(�VM <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �o�\ Ha�c�c y2S �9c-2y24 <br /> PhonrJE-maJ � (t � YC p f' 'V�'1 <br /> 6UILDING PERMIT APPLICATION CONTRACT PRICE OF WORK . K <br /> Eris6ng Use of Bmidmg HEAT SOURCE <br /> Proposed Use cf Euilding � Gas� Electnc_ Otner_ <br /> Building type��.,Single Family _Duptez_Townhouse _Mul1i-Family _Commercial <br /> T e of ro ecf. New Addi�ion Remodel Re air T.I. Si n S rinkler Demolilion Chan e of Use <br /> DESCRIPTION OF WORK(addrt�onai sparepm��dedan ine backl <br /> ��� S Fk'— w��r-1� c��--�-�c�E� 5c�ru q e <br /> Q A�Sz c � � � o s-oo 3 <br /> MECHANICAL PERMIT APPLICATION PLUM6ING PERMIT APPLICATION <br /> TypeolProject: New_Adtln _Alterotion_Repalr TypeofProject: �New_AAdn _Aileration_Repair <br /> Show NumCer fp)o!finures Show Number(a)ol finures <br /> A/G�-ah�andling umts Toilet <br /> Forced air s slems Bathtub <br /> Gas pipin Lavato wash hasin) <br /> / � Waler heatei / Shower <br /> Gas fire lace / Kdchen sink 8 dis osal <br /> ( Gas ran e Dishwasher <br /> Clolhes d er Clothes wash^r <br /> Range hood Waler heater <br /> [xhaust fan Smk serncel6ar/mo /etc. <br /> Heat um Backflow preventer <br /> Uml hcaler Urinal <br /> Boder Dnnkinq Pounlain <br /> Refri eration Flomtlrain <br /> Woodslove Grease trap <br /> Oucting Rool drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number o(Heads Olhec <br /> i�em0y wnM Oiat I�ave reae ana ciamined Ihis eFO�,�tion anE Anow tt�e same ta Oe Iruc and mrted.AO pmvnions ol laws and oNmances Boveming��¢rype ol won will Ec mmp4ea <br /> wt�wbel�er speafieE�emin or nol T1ie granimg of a Oeimn Oaes not pmsume lo qrve oulhorOy to naNtc or�ncel l�e pmvuion o1 any oNer slafe oUoral law mBulating mnsWdion <br /> TTaI I am auNomeO�y Ihe owner a1 Nis petry�o petlortn I�c woA for wM1ir1�appfra0on s maae an01 mmply mN Ne Sla�e Conlydqors Law 1B 2]ftCW dnE Z96.1DOA WAC. <br /> G �lI/ 1�� <br /> O ned ut�orizeA Fgent Si Nre Date (Revised 6�IOtt) <br />