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: PR PERTY TAX# PERMIT# <br /> 72 /,PAtNAF,p,� te14,-eE"�T 9,12 0,3v 3 7500 606?Y / k 1 (10el-D m <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER r,eE"77.,J/7)VV MJri ,e/7--y Phone/E-mail Vi-S'%5 92Z Z- <br /> Address 3/0 7 (GYBE / yr ,ZC77 City/State/Zip E-,t,� ,r/14 <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 CONTACT FOR PERMIT <br /> Phone/E-mail el/Z-<-5-06.397 /P<5/l//v rozi.G <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK- Z F. S7 2_ <br /> Existing Use of Building HEAT SOURCE:/ <br /> Proposed Use of Building Gas c1 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 /> DE CRIPTION OF WORK(additional space provided on the back): <br /> - /_ /+/�Gr/ 45-WY/t/6 / /1/e7-6// l,//1✓Z7) . " <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 I 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 I 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 /> I 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 I am authorized by the 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 298.200A WAC. <br /> ca0ner!Aut id Agent Signature Date (Revised 3/2013) <br />