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10333 19TH AVE SE SHIFA HEALTH 2016-01-01 MF Import
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10333 19TH AVE SE SHIFA HEALTH 2016-01-01 MF Import
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Last modified
4/14/2017 8:58:06 AM
Creation date
4/2/2017 9:56:11 AM
Metadata
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Template:
Address Document
Street Name
19TH AVE SE
Street Number
10333
Tenant Name
SHIFA HEALTH
Imported From Microfiche
Yes
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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVECES <br /> 3200 Cedar St , Everett, WA 98201 425-257-8 10 FAX 425-257-8857 v.v+nv.everetlwaorg u <br /> ' d� � �/'Z 'a / <br /> SITE ADDRESS: PROPER7Y Tnx p P RM T� _ <br /> 3 t4�^ SE. �e�,r ''!� A. <br /> LEGAL lor new cc�st�ucLon Sho1 PlaVsuOtlrvision I.ot No._ (altar.h copy ol long le9al tlescriplion) <br /> OWNER �'j���� r?p (,S L� PhonelE�mail <br /> Ptl(lmss ` q � Q Cityl5lalelZia f,11 i I Q 8� <br /> APPLICANT: _O�vner _OwnefsAgent �Comrector _ComraciofsA9ent _�fenant�R.��s�,•�nao.�����oi��:�-i��ominoc.�n�oa��.oa�nrn:oace� <br /> CONTRACTOR 9YAVD Cd�'�W..���W� ( tate Lic. #�YaJ�D�.OB7�J M Gty Bus. Lic. # 53 <br /> 4dCfe5, '�� ?,�� L• 5►�' L �lY�• /�• � PhOnCicma�l '�,�Ip' �j�1 <br /> TENANT BUSINESS MAME CONTACT FOR PERM�T <br /> Cj�l*A �If1��� Q�..�-L Pnonc�Ema�� �l25- 3 • -ID <br /> BUILDING PERMIT APPLICATION CONTRACTPRICE OF WORK �`��OLL1. °� <br /> Existing Use of BuJding HEAT SOURCE� <br /> Proposed Use ot Build�ng Gas__ Eiectr�c_ oine�_ _ <br /> Bwlding type: ,Single Pamiiy _Duplex_Townhcuse _A"ulti-Family _Commercial <br /> Type cf aro�ect- New Addiuon Remodel _Repair_T.I. _Sign_Sprinkler__Pemohtion_Change of Use <br /> DESCRIPTION OF WORK(acd�ncea�sr,ace preadea on ine 9a;�1 <br /> =wup�ove �,,,,��,�e- -Eo �tstt� c�,.�ial sp�..� � add 3 lo��M•oaro5 C�tw►) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> iypa ot Project: _Now_Adtln ,_Alteralion_Repair Typo ol Projecl: _New_AaAn ,�Alteration_Ropai� <br /> Show Num6er(Y)olliRfures Show Number(MJ o/(irfurrs <br /> I AIC—av handling mvls �fotlel <br /> � Forced air systems Bathtub <br /> Gas piping I Lavalory (w2sh basin) <br /> / � Waterhea�er I Shc:ier <br /> Gas f�iaplace ! Kitchen sinh 8 disposal <br /> Gas renge I Oishwasher <br /> � Clothes dryer � Clothes washer <br /> Range hood Water heater <br /> � Fxhaust fan Sm<(service�badnwpletc ) <br /> Heat pump I Back(tow preventer <br /> Uni�heater Unnal <br /> ' Boder � D:mkmg Pouniain <br /> � Refr�gerauon � Floor drain I <br /> � Woodstove I Grease trap �, <br /> Ducting � Roo(drains � <br /> � ���h„� M19�dical Gds <br /> SPRINKLER ! SUPPRESSION SYSTEM O her <br /> Number of Heads � O!her <br /> I hemby cen.ly iha�I�ave read anC ewmmed iMs apPLw'wn an�Fnon P.e same to Ce Ime antl cmren All pwviswre cl laws,n�oid�nar,ces goveming i�is rype ol woM1.wdl Ce wmphea <br /> w�;n wnetper specdmd nerem er not T�e 9raNin�ol B permf.Ooes not D��sWne to qive ad,4or�y to ne��:e or carcel tne D�ovision c'any alner sta'n o•lowl la,v ragulaLng ra.�stmclion ' <br /> inal I am au:�oi4eC Ey Inc ownef o11I'�i5 pmFeriy lu pedOrm�ne wo�k lor x�¢n aOG�wLcn�S made anA 1 tOmply w�'��he S'ale Cor Vatto�s Law 1 B 27 RCIY anU 7%"e00i�11'AC <br /> v�� L �'�il� ��• /Z• /y <br /> OwnedAuf orizedAgen15ignaturc Oate fRevrsedJROt3) <br />
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