Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> GITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.eve3 tfivi.or� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �r/ PROPERTVTAI(N P RMITiI <br /> SITE AD;RESS: ^ 3 r�� �Y S,F . 'r ��W — <br /> LEGALIor new conslruction: Short Plallsubdivision g ��C����"r� Lot No.� (atlach copy ol long legal descriplion) � <br /> OWNER - �� oY�'1Q�(� Phone/E•mail a5- 3�is- �a53 <br /> ` p o� <br /> ddress �,s� � - �'� S, , /�•)-�� City/Stale/ZiP �y,�i,-{{ �.1/f <br /> ApPLICANT: Owner OwnersAgent Coniracmr _ContracmYsAgent _Tenant(m��av�o.aeabnero!w�s�mo-omme�rmao.wammesp�) <br /> CONTRACTOR O�J L 8 I Lic.# COE Bus.Lic.# <br /> Fnone/Email <br /> ddress <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT' �� <br /> �,hoV�(�.a. ��rn <br /> PhonelE�mail as- 3 S" ��3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEAT SOURCE: <br /> Existing Use of Buildin3 <br /> Gas Electnc_ Other_ <br /> Proposed Use of Building <br /> Buildingtype: �' SingleFamily _Duplex_Townhouse _Mulli-Family _Commercial <br /> T pe of project: _New _Addition Remodel _Repair_T.I._Si n_Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK ladtlitional space providetl on ihe bace): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot PraJect:� New_.4ddn _Ailerolion_Repair Type of ProJec4 _New_Addn _Atteratlon_Repalr <br /> Show Num6er(N)ol llxfures Show Number(aJ ol flxtures <br /> A/C-air handling units Toilel <br /> Forced air s slems Bathtub <br /> Lavato (wash basin) <br /> Gas piping Shov.�er <br /> Water healer <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ren e <br /> Dishwasher <br /> Clolhes d er Clothes washer <br /> Range haod Water heater <br /> Exhaust fan Sink service/badmopletc.) <br /> Heat pump Backtlow preventer <br /> Unil heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigerelion Floor drain <br /> Woodstove Grease tra <br /> Duclin Roof drains <br /> Other Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM Other: <br /> Number of Heads Other. <br /> I here�y certify that I�avo rcad un�examinetl Ihis apPlkalion ona knmv lho samo to be Irue end mrtect All provisions ol lawa and arGinencee gaveminp Ihia lype olwotle vnll be complied <br /> wah w9ether specifetl�erein or noL Tho grnnling o/a pertnii tloes nol P�esuma l0 0^'e authoKy loviolale er canttl l�e provisbn olany ol�e�Slate o�latal lawrepulaing consiruotion <br /> Thul l am aulhodzed by thc rnvncr ollhis propchy lo pedorm lhc wod forwhich epplication 0 matle and I<omply wdh Nc Sleta CanVaclon Lew 1827 RCW anC 298.200A WAC. <br /> ��1 '.��,�-G�-- ��_es� �-I! -13 <br /> OwnerlAuthorizea Agent Slgnature <br /> Date (Revised N2072) <br />