Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wuvw.everettwa.org <br /> APPLICAT10N5 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROiERTY TAl(N P RMIT A <br /> 10123 /Yler�d�vn AUG Do396400oo38oZ 2 - <br /> LEGAL lor nea mnsWdion� Shorl PlaUsuDtlivlsion �ZO Z'O��—O(7 Lol No.$ (attaU coDY of long legal desaiOUon) <br /> OWNERH4ack (iro�hars Hovner PhoneJE-mail�ks-zvo-zyzy '�elphnucf�b�+br�z,o�+ <br /> Aatlmss 31�2 �7 ��1� �� CirylSlatelLip MUf SU 1 �le "1 �j C7� <br /> APPLICANT:�Owner Owner'sAgent Contraaor ContractorsAgent _7enant�m�air,Hoeaie�rermm�Y��r�m�mem.,brmoo.w��m.v.w1 <br /> CONTRACTOR �-tQa�k QfD+hPfS F-�D W1PS L 81 Lic.# �4� a�� �Z�Z COE Bus.Lic.# <br /> nadress ZZ, ��+h A �C � Y SUi�le PhonrlEmai� -j�jV•2yZ�! �UP1Q�G4r4�jrt ,�� <br /> TENANT BUSINESS NAME CONTACT FOR CERMI Z�.�0 � <br /> Soe� r� i t c qz.s- y z 9 <br /> PhoneJE-mail � �� ChC.�QC bre�tiE'rS� fv�"� <br /> BUILDING PERMIT APPLICATION CON7tinC7 PwCE oF WORK I S� k <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building c.5 F� Gas Electric_ Omer_ <br /> Building type: �Single Faml�y _Duplex_Townhouse _Mulfi•Family _Commercial <br /> T e of ro ect: New Addflion Remodel Re air T.I. Si n S rinkler Demoliuon Chan e of Use <br /> DESCRIPTION OF WORK(addrtiona�spaoe pmviaed an me back�: <br /> Cac��I�C�' IJ e W S�(Z- <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJact: �New_Addn _Alteration_Repair TypeofProject: New_Atltln _,Alteralion_Repalr <br /> S�ow NumDer(M)o/fixiures Show NumDcr(R)o!fixtures <br /> FVC-air handlin units I 7oilet <br /> Farced air s stems Bathtub <br /> Gas pipin Lavato (wash basin) <br /> � Water heater Shower <br /> I Gas fireplace Kitchen sink 8 dis al <br /> Gas ran e Dishwasher <br /> Clothes d er / Clothes washer <br /> / Ran e hood �e <br /> Exhausl(an Sink(service/bar/mapletc.) <br /> Heat um BackOow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Refn eralion Floordrain <br /> Woodslovo Grease trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I�ereby rcrtdy Mat I�ave reatl anE e�mmine0 tnls appl�lron and Mow Ne same lo Ce Ime anE correA.AE pmvwons ol law!:anU oNmances go�eming tliistype at xoA wtl br mmpGeA <br /> w�lh wl�emer speahea nemin or not.iTc g�anlm9 al a permA Goes na1 prewme Io givc auma�Y.y ta violate or�'an[xl t�e piov�;i0n ol any olner sLltc or bGl Faw mguldtlng oonsVudbn <br /> Th t I am aumor¢ed by me owner al Ci pmpeity lo peAarm Ne woA lor whitli apyr�tion k maCo an01 mmplywM 1he Slale Contraaors Law 18.P7 RLW anA 298.200A WAC. <br /> `I v <br /> i L-- 13^13 <br /> O e� thor zed Agent'�etu e Date (Revised 62012) <br /> �. ��i <br />