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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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Address Document
Street Name
19TH AVE SE
Street Number
10333
Tenant Name
SHIFA HEALTH
Imported From Microfiche
Yes
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mcso3 -o3R <br /> PERMIT APPLICATION 3 _�Z _� <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetf, WA 98201 -425-257-8810- FAX 425-257•8857-vn�nN.everettwa.org <br /> HPPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM <br /> SITE ADDRESS: PROPEqTV 7AX q PERMIT p <br /> /0333 / vr- 5 � "�/oi 1 3- <br /> LEGAL lor nmv conswclion: Short PoaVsubdi�ision Lol No. _ (aliar,h co�yof Innq Ir9�l deSCript;on) <br /> OWNER V A/jj� G���4r/ Phon=J6ma�l �--Z7� / ' (v/O <br /> naare;�, s �' /�UL CT SE a�y�sia��rz�a N1(/IGreelL A <br /> C01.fRACTOR Ly V1 1 ' c� J L 8 I Lic. .Y [�V�f�G�-�(J!�-v r ''�� <br /> ACAress �l � � '� �jGVI Phonc/f:ms9 ����'�I I � <br /> TENANT BUSINESS NAME CONTACT FOR PERh71T <br /> �'>�IN Phon��E�mad �I�((.l�- a L �f�� ��K <br /> BUILDING PERMIT APPLICA'f10N CONTRACT PRICE OF WORK ?�7J <br /> Exisling Use of BuilCing_��CNI��j E _ HE�T SOURCE: <br /> Proposed Use of Buildinr� N � C}���t Gas k_ Eicctnc_ Oiher__ <br /> Building lype: _Single Famiiy _Duplex_Tovinhouse _�.tulti�Family K Commercial <br /> Type of project: _New _Ad�ition _Remodcl __Repair�T.L_Sgn_Sprinklcr_Demolition_Change of Use <br /> Descripiion of 4Vork(udd'tional spa,:e p�cv;�cAon tnc hac!): <br /> (-��"�10U�"IN6 F�e�c UvC" -�eR�(�Iac�NG �,,/iTN �IrareO QD'S Au.O 1✓a� STrPp�w,� ��Fwse.y <br /> � l�(i�[<,Ci 7 S� W(�!1 r/c��(t.�utn�l�e �„(p0� <br /> Have you started working withoul a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o(Pro�ecL• _New_Addn �Alteralion_Repair Typa of Project: _New_Addn _Alteration_Repair <br /> sno���m�„ec�/x�oi r.r�res Show Nurnbcr p)oI/ix�ures <br /> NC-nlr hantllinc�units TodH <br /> FOfGC(I 31f SYSICOIS � Balhluh <br /> Gas piph:g Lava;ory(�vash basin) <br /> �P/atcn c�.tcr Shower <br /> Gas fireplace KiIG'•en sink 8 disposal <br /> Gas ran9e Dish:�vsher <br /> � Clothes dryer � Clothes n,isher <br /> Ranqe hwd W�Ier hr.dler <br /> FxhaUs�lan --{I Sink(servicel6admop!e(cJ <br /> f-Icat U�����P —� � I f3achliov�prevcnter <br /> —� Und healc� � Urinal <br /> Railcr � DrinFinq Poimtain <br /> Rclnc�eralion Floar Ara�n <br /> Wwd,tovc � Greasc Irnp <br /> Duclinq Roof drains _ <br /> Olher I �vletl¢al Gas <br /> SPRINKLER I SUPPRESSION SYSTEM O�her: <br /> INumber o!Neads Other: <br /> I hereby certi/y�hat I lm��e mad,nd examined Ihis�pFl:cation and know U�e smne lo he true and correcl.All pmvision;ol lav:.;anJ ordinances,qoverning <br /> Ihi,lype ol�trock v.�ll 6o cornplieJ v.i1h whet0er spectlicd herein or nol.The yran�ing ot a permit Aoos no�presume in grve aulhorily to��iolatc cr cantel <br /> ihe provision of zny other stale or loa!I law regWaiinn cunstruction or lhe pedormance of mnstruction.Thr�l I am auihorizeA by ihe ov.ner ol Ihis pmperty <br /> to Pert i�he work(or�.�fii�h app:icalion is maAe an�t I en�plyv.ilh lhe Stalc Cr.ntrar.tors Lam 1827 RCW and 296.200 WAC l <br /> '1���� 3—r2—, 5 rZ <br /> horiz' cntSignaturc Oaic (Rev�5Cd7J2011) <br />
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