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.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX#i PERMIT# <br /> 2828 • B tv.4 , c.c.- D.A.,. b I ISf 7121 I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long /legal description) <br /> ,BI#imdescription) <br /> {t <br /> OWNER DEV. LT-z,, Phone/E-mail -1 S' 5774—252- h - 4 alum,Q*4 <br /> O <br /> Address 2.1 2wf']j v <br /> -�/E, eke,tf ,: City/State/Zip EJCVGi, Wq, `!S92O <br /> APPLICANT: Owner x Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR r , C)t4"Mg State Lic.# City Bus. Lic.# • <br /> Address z, ( 20 /-A f77 Phone/Email 425---Z$Z- t 24. <br /> TERAATIRTSINESSTAITE CONTACT FOR PERMIT • <br /> No Ter. `/ Ver L thdber1' @ 42S-'? 3-` S7 <br /> Phone/E-mail �(�Ke LNte�im7c G-A 4u...CAP_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK J <br /> Existing Use of Building G6t41.402,Cfat_ HEAT SOURCE: <br /> Proposed Use of Building // Gas .< Electric_ Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I. Sign Sprinkler X,Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <br /> Demo tifio., Roil -4 swete. arxiAr fN446G7 RemegNEL of o irCE Aivo <br /> ResrRooM 4RRA5. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: New_Addn ^_Alteration__Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping I Lavatory(wash basin). <br /> Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> I Ducting l ' Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether 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 oft.' :roperty to perform the work for whichi� application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> �� �/ , 7//7/O(5_— <br /> Owner/Authorize t Signature Date (Revised 4/2015) <br />