Laserfiche WebLink
PERMIT APPLICATIG <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# PERMIT# <br /> iI0 \4 Iq'l(' Ove SG ,S 1e. I 1 • p-,6 f() —OO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attachtcopy of Ibn/g,legal description) <br /> • <br /> OWNER (06\S� ('�,�;� c( L Phone/E-mail Ct-Z( S/ Z.6Z0-11-5 `f(U�0p f <br /> Address i)0 4Dx- 1 3q 3 " •t�1Q city/State/Zip '' ((;0A4_ l D �I U <br /> APPLICANT: Owner Owner's Agent —Contractor Contracto'sgent Tenant(must provide a letter of consent from the owner to dp work in the space) <br /> T — C i?- _ <br /> CONTRACTORr Jn fc., Goa, J 1• ' r1 T ic.# (02 366 I/4-0 6#y-Bus. Lic.#E P�ki?C��f(,� <br /> Address .. ? ��5 5 , " . • • _`g <br /> OA (�J Phone/Email(z 53)z 2g- q tA 3 <br /> ` ` ' ` A ' RN/GU/11\4 <br /> A� S114ip CONTACT FOR PERMIT1I I <br /> 0 \00ti1 �,Iail 1.s an S P0. R,/GUI 1"I Phone/E-maill'�l3/ 3� �6 L1Jla e I1/L(✓1V1� VW�iulGi(I.1.-DM <br /> i DM <br /> BUILDING PERMITCAPPLICATION CONTRACT PRICE OF WORK OO )5-11:1/01-A-1114 <br /> v <br /> Existing Use of Building Jh,C� 11 HEAT SOURCE: <br /> Proposed Use of Building 1's MGL ClPg St/yve. Gas a2` Electric Other <br /> Building type: Single Family Duplex_Townhouse —Multi-Family K Commercial <br /> Type of project: New Addition -6 Remodel Repair T.I. Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �c c) Qc � T csz4 ,mg m 2ck +0 be eA - <br /> c ' 1 - • ice' c��'11.lfi�.�`i C UCC- 'f�i2 cu %,' ,.i •i- s�7 1�,t,�wl�lr6' <br /> MECHANICAL PERMIT APPLICATI ''' P-71 BING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: New-KAddn _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 Lavatory(wash basin) <br /> 1 Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) . <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> I Boiler Drinking Fountain <br /> L Refrigeration Floor drain <br /> Woodstove Grease trap <br /> 1 Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM `) I Other: SPC', Pe c.4cce.. Ckciir <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 erein 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 a on d 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 /> 20SOwi 7-2015— <br /> Owner/ <br /> ner/ uthorized Agent Signature Date (Revised 4/2015) <br />