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# P RMIT# a <br /> ;2oz)/ a)/L-JILT �fi Cz' i l% l.�/4 4-105 / -0/57—c7r) ) 01- CO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 4(2L • zAoI Phone/E-mail W -Kgkc/c T7''r:rTrcr�� <br /> Address v2ec/ 147/¢L N ct r ,$-t F1/E/Z.�=7! LoCity/State/Zip`_ �z:%lr 60,4 y��G j <br /> APPLICANT:_Owner _Owner's Agent _Contractor X' Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR /4.)401.64e_ snl STZjc"r o-- State Lic.# City Bus. Lic. # <br /> Address/5-C}C� (' 5+ ('/ Er Z3 Phone/Email t745-,35I-7i3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> T&Jur cAJ/4 -K r'- 41Z5----35-?—7�s--2, <br /> Phone/E-mail w--L k/' C."45 7«'K 6C.L/CLOS/2 e_6144 <br /> BUILDING PERMIT APPLICATION ,CONTRACT PRICE OF WORK <br /> Existing Use of Building . r` K HEAT SOURCE: <br /> Proposed Use of Building 5 Fg 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 xDemolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> f-*Vete' N 6 /-fL'-7,2e— <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 j Lavatory (wash basin) <br /> Water heater ! Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood I Water heater <br /> Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration ( Floor drain <br /> Woodstove I 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 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 296.200A WAC. <br /> /.5 —f y <br /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />