Laserfiche WebLink
� � <br /> PERMII' APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Sl , Everett, WA 98201 425-257-8810 FAX 425-257-8857 ���nv everettwa.org <br /> SITEADDRFRS—i, /.--•— PftOVERTVTAXIt P(R'�11i# <br /> !__ !o/T��F- i_�Eve.-�!� o0 o82.ct�Gba/o , I- (�D'L <br /> LEGAL'orne'�•�con;Uudion ;I��uriPlaVsuGd�visioM^7sS�N_V�ew T�1G7s �o1NoL ;a!lachcopyc!:englega�tle cnpt�oni <br /> OWNER /VOri"�WCS� (JG>�/Q' L�� Hhone�E-mai yzs3���-8ys� e{� '— � � �//�.� <br /> AAAiess3�z, -T ! OY ,I N �/>i! ,I Ciry/SIaIe�Z�n Eve����i �� 9g LD7 <br /> APPLICANT: _�Cwr�r _Oe�neYsngent __Conlraeio� _Conlraclor'sAgeN _Tenar�,��.T-:i;�,�.�,.;��.,n:rro-.;e�ir,o,,,��o�,� ,�oa,..n_,ro�.c,-:� <br /> CONTRACTOR �1��72 �S O�/�7 B!� Sta�e Lc dNO T L����P City Bus. Lic # <br /> ;.aa�ts� Pro�c�em��.i �/25-3�.6-845/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhOrc:E-i^21 H �J �y O'D y.7� eV _N/� q/Zl�7. nl <br /> BUILDING PtRMIT APPUCATION CONTRACTPRICE OF WORK�� __ <br /> Fxst�,ng Use of f3wld�n.3 ___ _ ___ HEAT SOURC[ <br /> ProposedUseo`Bwldin� /1��W L'OqS�rua�bh Gas (_ Electric�l OlherLB7y 4�s <br /> Bwlding type. /�Sinqle Fam�ly _Duplez_To�.vnhouse _Mulli-Famil� _Commeival <br /> Type of pre�=c1 Nevi Addition _Remodel _Repair__T I Sign_Spnnkler._Demolihon_Change of Use <br /> DESCRIPTION OF WORK(adyd�onai spacepro�cedrn�tno back) <br /> �W V � �� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATIOtd <br /> Typo ol Proje[C �/ Now__Addn _Allcralion_Repair Type ol ProjecC �Now_Addn _Allcration__Repair <br /> Show Number(tl)ol li.fwes Shaw Number(b)al liifwes <br /> A/C—air hantlling units Toilet <br /> Forced air systems �alhlub <br /> Gas p�pin9 Lavatory(wash basin) <br /> i Water healer � Showe� <br /> Gas 6replace � Knchen sink 8 d�sposal <br /> / Gas range I Dishvrasher <br /> I Clolhes dryer Cbthes washer <br /> Range hood � � 1 Walei heater <br /> S Cxhaust fan Sink (servicelbarlmopletc.) <br /> Heat pump � Back(low prevenler <br /> Und heater Urinal <br /> j [3oiler Drinking Fuuntain <br /> � Reingeration Floor�rain <br /> Woodslove Grease trap <br /> Ductmg Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other <br /> Number ot Heads � Other. <br /> I nereCy cenity ihai!I�.ave reatl an0 esam�ned I�is app��wl�on anA knew�Oe,amo lo�e W e antl corteG All pmvisions ol Iaws and ortlinactts govercing Ihis type ol work wiil be comG',ed <br /> wil�w�elper spen:ietl perem or no� Tpe gran!ing ol a Fertnil tloes not presume to grve nut�only to violate or cancel Ipo pmwsion ol any ol�et slale ar lowl law regulating ronslvcLen <br /> Tnat I am aulnonzetl Ey i�e mvne�ol InlS proDeriy�o pedortn I�e�w�k lor w��cn eDPliwhon is ma�e an0 l comply wlt�I�e Slale Coniraciors law 18 77 RC W anE 756 ZOOn WAC � <br /> .l��..�,,� o� -06-�y � L <br /> OwnorlAulhorized Agen SignaWre Ca'e lFewsed J�073) <br />