Laserfiche WebLink
PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everet a.orrp / t <br />Baal Ir:ATlnN.q ARE ACCEPTED FROM 8 AM TO 4 PM R ? 1 1 —v <br />SITE ADDRESS: _ 4 W <br />PROPERTYTAX# <br />MI _ <br />LEGAL for new construction: Short PlaVsubdivision O 3 Lot No._ (attach copy of longlegaldescription) <br />OWNER , C ) CIA <br />Phone/E-mail {I S 3 iflt— /, .5 <br />T <br />Address S 1 1-1 & t - <br />Gty/State/Zip <br />APPLICANT: Owner Owner's Agent Contractor Contractor's Agent _Tenant(mmtpm.uu kror ofeensem kom ine ewer lomwoA mme space) <br />CONTRACTOR ! L'Z_- <br />L & I Lic. # COE Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Pnone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK - v <br />Existing Use of Building (? L t / a IL. I HEAT SOURCE: <br />Proposed Use of Building ( � x l.'r ! t1 I Gas v- Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse Multi -Family ✓ Commercial <br />Type of project:. New Addition Remodel Repair T.I. Sin _.Sprinkler Demchtion ' Change of Use <br />DESCRIPTION OF WORK (additional space provided onthe back) : �I - <br />PQ 11 .t/Lj Xr fCtjocl / �1 5r nP CCu fJtC�. !Lw Gf t'�lWGQ �21&+ CV414 <br />t,c � S�Jff Ct9 P, <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typeol Prof l: _New_Addn —Alteration —Repair <br />Show Number (#) of fixtures <br />Type ofP oJect: _New_Addn —Alteration _Repair <br />\ Show Number (#) of fixtures <br />A/C —air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />I Lavatory (wash basin) <br />Water healer <br />Shower <br />Gas fireplace <br />I Kitchen sink & disposal <br />Gas range <br />/ <br />ishwasher <br />Clothes dryer <br />C hes washer <br />Range hood <br />Wate heater <br />Exhaust fan <br />I Sink isezvicelbarimopletc.I <br />Heat pump <br />I 8ackf1 evenler <br />Unit heater <br />Urinal <br />Boiler <br />Drinkin Fountip <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ductin2 <br />I Roof drains <br />SPRINKLER <br />Other <br />/ SUPPRESSION SYSTEM <br />Medical Gas <br />Other: <br />Number of Heads <br />Other: <br />I hereby cents that I have read and examined this application and know the same to be tme and corecl. M provisions of Taws and ordinances govern 9 this type of work will be complied <br />with whother specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply wth the Stale Contractors Law 18.27 RCW and 296 200A WAC. <br />OwnerlAulhprized Agent Signature Date (Revised 612012) <br />Me•ti bze — 0/, -q <br />