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 /> faAAPPACCEPTED FROM�8(AM TO 4 PM �1 ' t��1SITE ADDJ2�s$ o �g • Q�_ W. �qP�ROPERTY TAX#00. 6901-N000 <br /> _.� 6901- 00000 in P t ` °i– O ( <br /> LEGAL forlnew construction: Short Plat/subdivision1I(9OI l THRIKLot Noafr (attach copy of long legal description) <br /> OWNER \ri S A ix- Y lE. Phone/E-mail <br /> Address /RAO qg-- pi ' ik.) City/State/Zip .vGY-ez: W r:4o qg 4 <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR FA.)e.r( ..-1: j;)/ (CE`C'5 Lpr, L&I Lic.#gvykr8&o) 4 /4 COE Bus. Lic.# <br /> Addressro L j V Au NL. AQ(,Vjj-4�� Phone/Email �� —��4 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT c�Y• -'�Utr or-S . <br /> -Phone/-mail )1VTn �C"11s CCI is - , 4,1012 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3 A - <br /> Existing Use of Building 5 I^ HEAT SOURCE: <br /> Proposed Use of Building e..C. 1.--rn °t (C C©1O-1( Gas Electric X Other <br /> Building type: X Single Family _Duplex Townhouse Multi-Family _Commercial <br /> Type of project: _New x Addition Remodel _Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> I J-1- X IG'. Md 4-wou C j C. 1z-()1') 04-- <br /> i—x R - 'o (A/o c -"vg 2) <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 /> NC-air handling units Toilet <br /> Forced air systems / ; Bathtub <br /> Gas piping / Lavatory (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&d'-.osal <br /> Gas range Dishwasher- <br /> Clothes drye j Clothes her <br /> fiF <br /> Range h._s . 1 Water eater 1 <br /> Exha, fan I\I Si,' (service/bar/mop/et .) <br /> Ho.t pump YYY" n. .Backflowpreventer <br /> j nit heater i Urinal <br /> ' Boiler zz Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove Grease trap <br /> Ducting i Roof drains <br /> Other j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 ether sp edNein 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 /> at I am author).-d by th 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 /> _-\._ . /OP1-Ii'tISLI <br /> 'lz <br /> J <br /> Owner/Authorized A.ent S nature Date (Revised 6/2012) <br />