Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINC{MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8870 FAX 425-257-8857 v✓ww.everettwa.org <br /> SITEADDRESS: r PROPERTVTA%k P� ITs2 JOI^ <br /> � C�rz�✓1� o7I�Oo� OQ O� L <br /> LEGAL for new conslruclion: Short PlaVsubdivision Lol No._ (altach capy ol long legal�fescriplion) <br /> OWNER L Pnone�e-mai� �/�"jZt/��SZ/`f Sa�7 i ���'��"�a <br /> Address PQ .�p CilylSlate2ip /j�/�/ CrcElf �(/ �po�p� <br /> APPLICANT:_Owner _OwnefsAgent Contractor ConlraclorsAgent TBf1Bf1�(musl:mNOoalorterolwnsemhomt�ec+'nortoDawo�mlMSWco) <br /> CONTRACTOR � .y1 e S State Lic.# City Bus. Lic. N <br /> AOdress ,Cj,qvT,e P�onelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonePd•mail <br /> BUILDING PERMIT APPLICATION CON'fRACT PRICE OF WORK <br /> Existing Use of Buiiding HEAT SOURCE: <br /> Proposed Use o(Building Gas_ Eleciric_ Ot�er_ <br /> Building type: rSingle Family _Duplez_Townhouse _Multi•Family _Comm:rcial <br /> T pe o(project: New Adddion _RemoCel _Repair_T.I. _Sign_Sprinkler Demoldion Change of Use <br /> DESCRIPTIONOFWORK(addd�ona�specepmwdedontheback): I�3g � �G� <br /> �o�4C7Tc✓1 0�� 4 /!Z✓ S�F/1 4S5 � g4(a�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJect: Now_Addn _Altaration_Rapalr Type of ProJeU: _Now_Addn _Altorallon_Ropalr <br /> Show Numbe�(NJ ol firlures Show NumDcr(N)o/fixfures <br /> A/C—air handl�ng units Todet <br /> � Forced air systems Bathtub <br /> � I Gas iping Lavato wash basin) <br /> � Water healer Shower <br /> Gas fireplace I Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clolhes washer <br /> Ran e hood R"`� <br /> Ezhaust tan Sink (service/badmopletc.) <br /> Heat pump I Back9ow revenler <br /> Unit heater � Urinal <br /> I Boiler Drinkin Fountain <br /> I Retrigeration I Floor dram <br /> Woodstove I Grease Ira <br /> Ducling Roof drains <br /> Other Medicai Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Other <br /> � Number of Heads I Other: <br /> I�ereby ce�dy Nat I have read anC examineE t�is apD���lion and know the same t�be We and correp.All pmvisions ol laws onE orCnances goveming Ihie rype ol work w7.i be comp6eE <br /> witb wfietller sD��K'a�eR�n or nd.The granbnp ol a permil does nol presume to gne aulnority to violale or cancel Ihe provision ol any e:ner slate or lotel law re9�letinq ronsliuciron <br /> Thal I am aut�orizeE Dy Ihe owner of this Dmperry to pertnm t�o xrork lor Hrich appl�wtion ie ma0e an0 t compiy w�tb i�e Stete Conlradors Law 1827 RCW anC 296 200A WAC <br /> /� (� J3 C3 ��� <br /> O erlAutAorizeA Apent Slgnafuro � � �atc (R?vised 3?0f3J <br />