Laserfiche WebLink
pERIlIIIT APPLICATION <br /> BUILDINGIMECH4NICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �-I �-I- <br /> SITE ADDRE55: e`�=f'rf pROPERTY TAR p P �T�'� 1� . � <br /> i v ; =->:'.4Lc, G'R SGU �7F.'.=�' ' " <br /> LEGAL for new construction: Shotl PlaVsubdivision Lot No._ (altach copy ol long legal description) <br /> j'_CC-4-c.lNi��/ p�i �Z�-✓'ZE.7-C�7Z7 <br /> OWNER�' {�uE-Z- �'�� PhonelE-mail ��- Q��' <br /> -�'�'Jt� V<-.I;�LLEiVC (l�>tiY S City/Slale2ip G L�LI� (( �(/j� (�,ZC�� <br /> Address <br /> APPLICANT:_Owner Owner'sAgenl ,_Comractor ContraclorsAgent _Tenanitm��:iP�o��aooi:nerau�sem�romm,o,.��er�om..oM.�mefe>�el <br /> CONTRACTOR � � L 8 I Lic# COE Bus.Lic.# <br /> PhonelEmail <br /> i\ddress <br /> TENANT BUSIN[SS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT �PPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Buildina / t 5+"lZ-��r��L HEAT SOURCE: <br /> Proposed Use cf Building Gas� Elecvic_ Other_ <br /> Building type: �Single Famity _Duplez_Tmvnhouse _MWti-Family _Commercial <br /> T e of ro'ea: New Addition Remodel epair T.I. Si n Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(addRional space provided on(he back)'. <br /> MECHANtCAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _Now_Addn _Alteration_Repair Typo ol ProJoct: _New_Addn _Alteralion_Repair <br /> Sirow Number(N)o!/ixtures Show Number(N)o/IixNres <br /> NC-air handling uni�s I Toilet <br /> Forced air systems I Bathtub <br /> Gas iping Lavalo (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> I Gas ran e Dishwasher <br /> Ciothes d er Clolhes washer <br /> i Ran e hood Water heater <br /> Exhaust fan Sink(servicelbar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit healer Urinal <br /> Boiler I Drinkin Fountain <br /> � Refri eration I Floor drein <br /> � Woodstove l Grease trap <br /> � Ducting I Roof drains <br /> , I Other__ � Meaical Gas <br /> SPRINKL[R I SUPPRESSION SYSTEM � Other. �J 'T!L .SE/�V%C_� <br /> � Numher ol Heads Other. <br /> I hme0y cendy that I have reaC and eRamined Ihis appbtahon anG knmv t�.e same to ta Vuo and rorreC.AA pmvis�ons cl Imvs a�d ortlmanres goveming Ni,type ci work will�e compiietl <br /> w.nh whet�er speuLed herein or noi.T�o g ranting W�ertn0 tl.es not presume to giva autharity to violate or cancel irc pioeis�mn o I any omer s;ate or Ixal la.v reg�lanng constmaion <br /> ihat 1 am eut�orized Oy t owner ol t�ia propeny D orm mc�wrk'cr xhl<b appiiwtion ia maCe enE I mmply Mnn Lhe S�ate Contracten L a.v 19 27 RCYV and.'��i 2JOA C:AC <br /> �� <br /> .4�/% '�1��-�'L� �',=�i� �013 <br /> -Owner/Authorizod Ag nl Signaturo ate i�ev�sed 62072) <br /> s ' ' ._ - '__ <br /> —.__. _ . .__.__. <br />