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# R i L <br /> -)0� ✓CIC�6oc D{ lib � �1 <br /> � 5 OCVX 9000V —[" Oil <br /> LEGAL for new constructionhort Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Ca/ �U5 Chao/€.5 Phone/E-mail LI25 -7,57 " X37 <br /> Address <br /> i(;7_.. 1 ) Z*3 p) Al E City/State/Zip utile l I . ti-,) 14 `7,g G/I . <br /> APPLICANT:_Owner _Owner's AgentContract(or _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> (^, <br /> CONTRACTOR ( c cl me, \ -ov 4� .pr X Coil ritate Lic.#t,C 3 j t 2- I qro/ City Bus. Lic.# O5'/if, <br /> Address l�yb6 ii _pi 51,J a,,t vil1r.1�C �r'n6e r w C1�p ` Phone/Email z CC 776i—3-70e) <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT _ <br /> Phone/E-mail 7,06 70 —_,5-7 O, C-r'lkd 6 cc/41-Cc X5r'4 Q,tom <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 6, F Y"3, 2_ <br /> Existing Use of Building ,Y (core HEAT SOURCE: <br /> Proposed Use of Building c-.y C Ct J` e Gas / Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family ?( Commercial <br /> Type of project: New Addition )Remodel Repair T.I. Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1 / <br /> We w;l( (e v'.e vl t ov if 11 cti vN o v. - (oc of (off'/,+-r i j ux,,t(/ c._I v.,2 en't s' "c(i i) <br /> 1.11- 3n .g'2e- /10 ✓v� 4& . <br /> -ii�,5e a IK' "wl . wC <br /> e it( Vce.nioV evtiry <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn X Alteration_Repair Type of Project: New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> INumber of Heads Other: <br /> I hereby certify that I have read and ex fined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be compl <br /> with whether specified herein or not.T e gran' Ter 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 which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authors Agent Signa Date (Revised 9/2014) <br /> I/2 <br />