Laserfiche WebLink
� <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 w�vw.everettwa.org`/Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `a 6 <br /> PROPERT'TAxq ,1�/ � '/�� P�RMI7p � — (� <br /> SITE ADDRESS: � � U �o / `�""� � <br /> ��3�(� �le.rf� l1 � � 4 <br /> Lot No._ (atlach wPY oi long legal tlescription) <br /> I.EGAL(or new wnstmcUon�. Short P�aVsubdrvision__�— I' �7 <br /> 1 PhonelE-mail '1,1 �� 5 J5 � ���� <br /> OWNER .JL ul' YV ; � � � <br /> �1 n � CitylStatelZip VG�L <br /> Adtlress ,1 ti�� 1�' '1' ( n < <br /> APPLICANT:_O�mer _O�mer'sAgent �Contrector _ConlractorsAgent _Tenam�m�+io�o.�aosmn��mw�+o�n�om�newTo�ioao.:on��me:ouo� <br /> CONTRACTOR �Z I�u ' �/ f D� G °i1 <br /> L&ILic.# r� LA �PIo.�l1 COEBus.Lic.# D. S <br /> �(� fj U„ 4.s � �f2 S �U 11 � L� Phone/Email ���a " � - 7� <br /> ntldress COtdTACT FOR PERMIT <br /> TENANTBUSINESSNAME ,jL�;r� JU�S� <br /> I 1� f� <br /> JL �`�1��1� �lLC. `�Lf � Il Pnonc/Email .?O(;,'�{ 1�(i _" � �'��I U�Z,I��GN'L ��� � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK II �i`�y <br /> HEATSOURCE: <br /> ExiSlingUseotBuilding � rtH �,�DFE�� — <br /> Gas_ Electric_ Other_, <br /> Proposed Use of Building 9.1��1�' <br /> Buildinglype: _SingleFamily _Duplex_Townhouse _Mulli-Family �Commercial <br /> T pe of ro ect: New Addition Remodel Re air T.I. Si n x S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(nddmonel spnce womded on the backJ: <br /> MECHANICAL PERMIT APPLICATION <br /> PLUMBING PERMIT APPLICATION <br /> Type of Profect: _New_Addn _Alteralion_Repoir Typa of Projecl: _New_Addn _Alleration,_Repair <br /> Show Numbcr�bl o/fixmres <br /> ShowNumbcr(p)o//ixtures �� Toilel <br /> FVC–air handlin units � BathWb <br /> Forced air s�istems . Lavalo (wash basin) <br /> I Gas pipin Shower <br /> Water healer . Kitchen sink 8 dis osal <br /> � Gas fireplace � Dishwasher <br /> Gas ran e � Clothes washer <br /> Clolhes d er � Water healer <br /> � Ran e hood i Sink(servicelbar/mo lelc.) <br /> Exhaust fan gackllow reventer <br /> Heat ump � Urinal <br /> i Unil heater ! Drinkin Fountain <br /> Boiler � Floor drain <br /> ' Refri eration Grease trap <br /> Woodslove Roof drains <br /> Ductinq �� Medical Gas <br /> � Other <br /> Other <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> 7� I Olhec <br /> Number of Heads <br /> I iicmby cenity l�al l�avo mad and eKaminetl Iliis apP�'wtlon and knorv Ino same to�e Irue and corted.All pmvisions al laws and oNinances govemin9 tl�ls typo oi work vnll bo comp'���J <br /> vnili v.nclner spcu0ed�erein or nol.Tho 9ranling ot a pemiit does nol pmsumo to g��c autnonly ta vblam or w��1h t�c Slalc Contractorls Ww 18 27 RCW,anE 296��WA���on <br /> Inal1 am aulhmmd by me owner of Inis pmpeity lo pedonn Ine work lar w�ich apphwlion is maEe antl I compy I <br /> � � <br /> �� � <br /> �,, � ll !9 LZ ,F��,=�d s�o,z, <br /> OwnedAuthorized� entSi�nalurc <br /> o�« <br />