Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Fverett, WA 98201 425-257-8810 PAX 425-257-8857 vn•nv everettwa oig <br /> (—17—Il/ <br /> $IT ADDRESS: PROPERTYTA%N P IriIJ O ` � <br /> � ) � Ic �i�.I�� �� 1/L � <br /> LEGAL!or nc�v consl�uct�on S�crt PIaUwCCirrsmn Lol�10 (ai�ach coG/ol iong iegal Ccscnpl!zrp <br /> OWNER � �� � (-� PhOnelE-ma�l <br /> ������ss , o� Sz�, 1�,,,�T �� v �,�Y�s����,�,P � �,��r* h. w oi 3�� 3 <br /> APPLICANT: Owner Owrer'sAgenl ��onira[Im _Ccr!iacleYshgect fenanlp".�iro�a��mn...��:;�...�r;..�-�.o.raaa�.:.+n:nni:��m <br /> CONTRACTOR (,4.`�ipl„� hjv�q si,;e��� a i?�//oh� � Zn/�� u�s. ��c. tt <br /> ne�-ess � � 7 5 ��t�il L N on� wi v� �c� r-honeiEma,� - �U- C7 S z � ��c�3 Z <br /> TENANT BUSINESS NA1dE CONTACT FOR PERMIT <br /> phonC/[-ma�I � 1 C � ��-/-� � � / <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�� U G <br /> Existing Use ol 6wlav�y HEAT SOURCE <br /> PropoSed Use of[�wiC�ng Gas [ieaoc Crt�er <br /> ��Jd�ng tyce �i�Smgie Famay _Duplee_Townheuse _L1uIti�Fam�iy _ ;crrTeruai <br /> TyFe of prc�ecl __ ��ev+ ___Aed�tion Remodel Rcaav ' T I S�ai _Spr�nF,ler _pemciitmn Change ol Us^ <br /> DESCRIPTIONOFWORKiae.':'o, r_c,rer.c, edo,r�er,�c;� -- -- - <br /> inS"fll�( ���ncue � l�r�7-�,�n�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Projecl: _Ne�v__AAtln _Al�eraiion_Repair Type ol�rojec�: _New__Addn _Alteralion_Rrpair <br /> Show NumOcr(a)ol lir(ures Show Num6cr(>)of li.luics <br /> h'C -av handl��ng unns � iodet <br /> � Ibrced air systems � 6athlcb <br /> � Gas pipiny I Lavatory(wa,h basm) <br /> I Water heater j Shor:er <br /> _ Gas hreplace I Kdd•�en sink 8 disposal <br /> � Gas rangc DisM:ashcr <br /> I qothes drycr I Clothes washer <br /> ! lianye hood Wdtn c�ate� <br /> � [xhausl lan � Smh(servicelbar/mnplelc) <br /> � � Heat pump � [3acknow preventer <br /> � Und hca�er � Unnal <br /> I Boiler Drink�ng Pounlain <br /> � Refngeralion � floordrain <br /> � Waodstovc � Grease irap . <br /> Ducling I Rooldrains <br /> � Othcr Metlical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I other <br /> Num6er ol Heads I Other <br /> I here�y ttfdy I�al 1�ave reM an0 e.am�neC IMt apph:auon dn�I.now IM same to Ee W e.�.1 conect All Ciovisians cf 12ws an�ot�-.�ances qeve�n:n9lh�s type ol woit wi7 pe comphea <br /> w�L�xnelner speaGea heiein or nel lhe g�an•o�d�Crrm]Cocs n:�l Cres:me b Grce a�lhor^y�s oulale or canrrl l�e f'ovisr..i^,I any tlpei s�,•^ot C�'al Inw rrgvlaing ce�slmdion <br /> 7Aat I um autnamed Ey��e onnn ol Nis pmperty to percan i�c ww\!e:w*�ch app'•W ben is na0e and�<ompty N�m I�e Sta;c Gmhac'rs L aw IB P 7 RCIY zrd 2a5 z�pA'.VnC. <br /> Ill � <br /> Ownc � �zedAgent5lgnature Uate �Revised3/.'OtJ) <br />