Laserfiche WebLink
From: 05/')"12012 08:35 #'809 P.002/002 <br /> i <br /> SgIIS1 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SI., Everett, WA 98201 -425-257-8810—FAX 425.257-8857—www evere�twaor �`/ 2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM <br /> SITE ADDRESS: bbl `7YV MNT� -7OnQOSSGU xIIrN S_OSZ <br /> LEGAL for newconsi utcchon Short PlaVsubdiviYslon_ Lot No— (amach copy of lung legal eusviption) <br /> OWNER ^�'1 11� 6 1 [�'1\G 1 PhonelE•meil 9�W 02 <br /> ✓(3S - 0-7 <br /> Address 'p(1 U' S Cny/SlotelZip Jefe W 9ci o <br /> CONTRACCTIIO_^R W Q Q L 61 Lic.NII <br /> Address IaJI] 132 PANe � �CIAk W 3`1 PhonolFmell • /-7 <br /> TENANT BUSINESS NAME CONTACT OR({QS ERMIT L}•1.Jr (o�J(O.7 <br /> TUI1C <br /> f hone/E-mail i CWJC' Y\[A t 1 <br /> BUILDING PERMIT APPLICATION ICONTRACT PRICE OF WORK _ i(gr'� f'+r_ <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Ges Electric Other,.___ <br /> A <br /> Building type: Single Family _Duplex_Townhouse _Multi-Femlty _Comme¢iel <br /> Type of project' _New _Addition _Remodel X Repair_1 1._Sign_Sprinkler_Demolllion_Change of Use <br /> Description of Work(adaaionel spece provided •rhe bscA): <br /> Have you started working without a pe"It? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _Naw_AEdn _Alteration KRepair Type of Project: _Naw_Addn _Alteration_Repair <br /> Show Number(N)of exturea Show Number(N)of 17rfuna <br /> A/C-air handling u a Toilet <br /> Forced airs stems Bathtub <br /> Gas I in lavatorywash basin <br /> Water heater Shower <br /> Gas fire lace Kdchen sink 6 disposal <br /> Gas ran a Dishwasher <br /> Clothes dryer Clothes washer <br /> Rango hood Water heater <br /> Exhaust fan Sink. servlcelborlmo /etc. <br /> Heat pump I Backflow preventet <br /> Unit heater Urinal <br /> BDllef Dunkin Fountain <br /> Refrigeration I Floor tlrain <br /> Woodstove Grease trap <br /> Ducling Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other <br /> I hereby certify that i have read and examined this apphcallon and know the same to be true and coma.AM provisions of laws and ordinances govemmg <br /> INS type of work all be compled oath whethm specified herein or not The granting of a pemat does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating conftnaction or the performance of construction.That I am authomed by the owner of this property <br /> to padorm the work for which application is made and I compGly1witthh the Stale Cohtraclors Lew TO 27 RCW and 200.700 WAC <br /> ✓I I <br /> nor/Authorlted Ageol gnalure Pale (Revised 2201 1) <br />