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:35 7h ( (C( A,,1 eil led.2404z$0�'004 , PJt/il"l#O f-D <br /> LEGAL for new consstrucctioon/: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER(,trt OF �YFy 7 Phone/E-mail 4Z5-'157'2rt4-yrel,R,r ate, /Aco .44. foe/ <br /> Address,3t (�, M-gT City/State/Zip rpe (,t-• ?'8Qp/ 7 <br /> APPLICANT: Owner _Owner's Agent —Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR G(77( D fr /02J4 � State Lic.# City Bus. Lic.# <br /> 2 / ZS•2J'� �l PeiAve-C <br /> Address % ebe, �$T, Phone/Email 7401 ��ft,4h4,Lrp v <br /> ?At/L.414.1.1 <br /> �L � <br /> ��`� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Gj <br /> 1 DIA P L1 f)I� Phone/E- 7,57. e-257. I r' L�f/ I OdrQ 7/ , <br /> cod <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building a► At,G' (4'/ 7 574 • HEAT SOURCE: <br /> Proposed Use of Building U 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 /> 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 /> 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 Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads i 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 authorize owner of this property 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 /> 1 VA, <br />