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 ADDRES� /� �*iwf.,� �� r� v TAX# , t� 1,��C p I.T(#� I j� I <br /> 2_ -� ?vC �� � I ) 0 1 3 <br /> LEGAL for new Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER G'viec-T ,/7L/�S/O✓�j Ct 6/7-#d,4,7y Phone/E-mail 1/2.„" ,› <br /> Address J Cy/ <br /> ; /5—V 7 City/State',e•• ��f' 9,zo <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 � (State Lic.# City Bus. Lic.# <br /> Address (Phone/Email <br /> TENANT BUSINESS NAME /4/01 4/6 3 CONTACT FOR PERMIT n •—W <br /> Phone/E-mail‘4"3"-.5-416 'le> aIVA C -1/1/d Gt_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK i'4/69�.. err) <br /> Existing Use of Building '-AA/ HEAT SOURCE:EA <br /> Proposed Use of Building Gas 'f,/ 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 /> 17/1 �(,� 11//17?-0 ) <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 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 3 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 _ Other: <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 taws and ordinances governing this type of work will be comp) <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 Iiir or by t .weer 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 /> ,,' (77X <br /> Owner/Auth, -. Agent Signature Date (Revised 9/2014) <br />