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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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. • �RMIT APPLICATIO� <br /> BUILDINGlMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257•8857 wvuw.everettwa.org <br /> 7 �aq�l S <br /> SITE ADDRESS: f,(� S'� PROPERTY TAJf Y P MIT F <br /> /0s�3 - uc. �i,,;f /O o10.�0 / o S - C70 <br /> LEGAL lor new constmction. Shon PlaUsuotlrvision Lot No (altach caDY ol Iong legal descnplion) <br /> OWNER �� V p�,G(, �• - �(j (« PhonelE-mad yz - 9.�9- �s � <br /> Address /jq! — z — � � f� City/Siate/Z�p � Cfle� �/(/A 9 Ql Z <br /> APPLICANT: _Ovmer _Owner'sAgem Contraclor _ConliacloiSAgen� __Tenant�musicm.ae+paeiotcc�smirtommeo.s�erua�.mnmmesoace� <br /> CONTRACTOR s y Slale Lic.!i S I U D1�S S�C� City Bus. Lic.#OSZBp y <br /> Address ��� N�/ � f JeC7�4� (�/A oneiEmail7,Q6-6ZZ" �ZO IN�C(.Q� �4 /U3 <br /> TENANT BUSINESS NAME CONTAC FOR PERMIT��/.�e �v Q� ' rp ti <br /> (� / 0.t � •r� f Ce�-r <br /> �r� J �IIQ/ � p�one�E�mail z0 — z �Q /17/Kf �.rT[N <br /> �j. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2 . Up �o,,�, <br /> Exisling Use of Building_ �Ok+►.CYC/g� HEAT SOURCE: <br /> Proposetl Use of Building Gas Eiear�c Olher <br /> Building rype: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e ol ro�ecl: New Addilion RemoOel Re air T.I. Si n S rinkler Demolition Chan e ol Use <br /> DESCRIPTION OF WORK(aetlitionai space proviaed on rne ecce)' . , <br /> INGN4�c -�� cc,� /tit�c�� C1cc-cJ/��c ��euf%oya� <br /> �e {�f�f <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pro�ect: _New_Addn _Alteratlon_Hopalr Type ol ProJecl: _Now_ACOn _Altaratlon_Repalr <br /> ShowNumDer N o/fixtuies ShowNum6er a o//ixtures <br /> NC—air handlin unils Toiiet <br /> Forced air s slems Balhtub <br /> Gas i in Lavalo wash basin <br /> Waten c�ater Shovmr <br /> Gas fire iacc Kitchen sink 8 dis osal <br /> Gasran e Dishwasher <br /> Clolhes d er Clolhes washer <br /> Ran e hood Waler healer <br /> Exhausl fan Sink servicelhar/mo fetc. <br /> Heal um 5ackflow reven�er inside bld <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Refri eration Floordroin <br /> Woodstove Grease Ira <br /> I Ouctin Rool drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otner <br /> Numher of Heads � Olher. <br /> I hereby cerlify tnal I have reaG antl e.am�n¢p ihis aDGl�cabon antl know Ine same lo 6e Irue anC cortect An p�o�rs�ons ol IaMs a�a orEmances governmg�his rype ol won vnll Ce comp <br /> with wfieNer specfieE he�e�n o�not ihe granbnp ol a permit Aoes nc;p�esume lo grve aul�onry lo oioLite or cancel Ihe p�avision ol any other sta�e or local law regu�ling wnstruclion <br /> T�al l am auUoraea Ey I�e owner ol lh�s piapetty la pe�om+lhe Noih lo�hfiic�applicauon i5 ma0e antl I Compy vnN Ihe State Contraclo�s LaH 1827 RCW and 296300A WAC. <br /> ��� . �,.�.. � ��2��s <br /> Ow erlAuthorizetlAgentSignature Dat (Revise04/2015) <br /> l / 2 <br />
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