Laserfiche WebLink
• � � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERM�T SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everethva.org <br /> SITE ADDRESS: PROVEHTY TAX k PER IT�1 <br /> 91 32c� AJrL 5�F�V G�LT -d <br /> LEGAL for new construction: S�ort PlaVsu6Civision�CN2�o1���c. �AQ-k Lol No.� (attach copY ol long legal description)��� , <br /> OWNER�pR-� Qp.C,.G.C. Ne0 C P�one/E•ma qz �[.S3 -2�00 <br /> nda�ess ��"� S�� oo ���� C�ry�S�aterzip �Jr�A-F�1T' lr+�, q�Zd� <br /> APPUCANT: Owner OwnefsAgent Conirac�or ConlractofsAgenl Tenpnl�rtws�pioHasaienaroiwnsmvmmmewmonoaoradmenev�l <br /> CONTRACTOR�j�p.T � Cr i-�C.. State Lic.#S�JalTp1-40p U City Dus. Lic. #L03-lJs b S�'� <br /> AtlOress /yyV��L . � Phone�Email SqYH�, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �'ON�J CP'�4rZ1'LG� <br /> Phone�E-mail 'Q7 7� 3 J�" b�Z <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use ol Buildmg HEAT SOURCE: <br /> Proposed Use of Buildmq Gas✓ E�ectric omer__ <br /> Bwlding type: ✓Single Family _Duplez_Townhouse _Multi-Family _Commercial <br /> Type of project: ✓New _Addition _Remodel Repair T.I._Si n_Sprinkler Demoli�ion Change of Use <br /> DESCRIPTIONOFWORK(ada�rionaispaceprovidedonrno�eck): Z G�� ���� � <br /> MECMANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projecl: _New_Addn _Alteration_Rapalr Typa ol ProJecf: _Now_Atldn _Alteralion_Rapair <br /> Show Number(N)of lixfures Shaw Number/N)of llxfurcs <br /> FVC-air handling units Tailet <br /> � Forced air sys�ems 2 Bathtub <br /> Gas i in /{ Lavatcry(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kilchen sink 8 disposal <br /> Gas range \ �ishwasher <br /> Clothes dryer 1 Clothes washer <br /> � Ranqe hood <br /> Eahaust fan Sink(servlce/barlmop/elc,) <br /> Heat pump Backllow preventer <br /> Unit hcater Unnal <br /> 8oiler — Drinking Fountain <br /> Refrigeration — Floor drain <br /> Woodslove Grease irap <br /> Ducting Roofdreins hoW1.�6 OJTS '. <br /> Other — Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> — Num6ero(Heads Olher: <br /> I hereby cendy Ihal I have reaE and ewan-�ne!t�is ap0uwtion and Mow Ihe sama to 6e Ime an0 correct.All proviswns ol laws onE orEmances goreming IOis IYOa olwod w!I De complie0 <br /> wil�w�el�er 5 cdie0 Oer a o1.Tna gra.ibng al a pertne Oocs nal pesuma Io qive aut�oray Io viomie or wncel ma pro�ision ol any ot�er stata a bwl law regulaliig consWaion <br /> Thal l am auth ue Cy�olt�is poperty to pe�orm I�c work lor w�icli applKalron is maUe an01 complY wn���e S�ale COMreclon Law 1B 27 RCW an0 296400A WAQ r <br /> � '�- 13-l q l` v <br /> OwnorlA horized Agent Signature Date (RevisedYt013) <br />