Laserfiche WebLink
PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 viavv✓.evei .1two oift <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Q _ Oct — I <br />SITEADDRESS: <br />W <br />PROPERTY TAX <br />�D �n <br />V <br />LEGAL for rew conslruc iw Shod Plagsubdivision Lot No.__ (allach copy of long legal descupllon) <br />OWNER A kC <br />Phone/E•maii 1+7 2,406' _ <br />Address ! '41 — Tr 50. <br />•' nI <br />Clly/SlaloRIC <br />rp I9 ( /„(A, <br />APPLICANT:_Owner _Owners Agent _�ZConlmctor Contfaetors Agent Tenant karrohonrrnl lmmlhe weer lode vakmlb fpup <br />CONTRACTOR rVrR6(WW STA.T644411ir RAMIL- <br />CONTRACTOR <br />L B I Lic. 11 EVEI2GSS 0220q• COE Bus. Lie. 01 W1 <br />Address 'I me, PACO:Ic- At-EVEWT.Willi 9S20I Phone/EmaA(rfzS) 252-'j1/1l <br />7ENA T BUSINESS NAME <br />CONTIfIACCrrT FOR RMIT <br />LO <br />Pltonelc-ml� 'T ZS 2 J Z — 31/tF <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building _ HEAT SOURRCC <br />d <br />Proposed Use of Building _ _ _ Gas_ Eledc_K <br />Buildinglype: _'�LSingieramily _ Duplex —Townhouse _Mulli•Famliy _Commercial <br />Type of project Plea _ Addition Remodel Re air T.I. Sign Sprinkler Demolition Change of Use <br />DESCRIPTION01 W(IRK(addfonalspace Providedontheback): <br />IN51kw A II,(:11 [Fr. 5)vc.TLLSS I4CV0Q tUmp <br />MECHANICAL PERMIT API LICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn,_Alteration_Repair <br />Show Number (#)of flxfuro: <br />Typool Project: _Now_Addn _ Alteratlon_Repair <br />Show Number(#) of fixtures <br />AIC— airhandlin units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Water healer - -_—�—Shower <br />Lavatory wash basin <br />_ <br />Gas fireplace <br />Kitchen sink 8 disposal <br />_ <br />I Gas range <br />Dishwasher <br />Clothes dryor <br />Clotheawashrr <br />_ <br />Renge howl <br />Water heater <br />__ ---� Exhaust fan <br />Sink (servlcetbar/moplelc. <br />Henl Pump_ <br />Backflow, preventer <br />Unit healer <br />Urinal <br />Boller <br />Drinking Fountain <br />Refrigeration _ u <br />Floor drain <br />Woodstove <br />Grease Ira <br />Ducling <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />_Other: <br />Number of Heads <br />Other: <br />I hemhy r edify that I have mad and emmined this epphcalbn and snow the same to be Imo ear' correct. Aa Pmvistons of laws nod ordinaetns 0o arming th:s lypa olwmk wee be comPred <br />wah whether sponged hrre:n w not The grnnlbg of a permit does not presume to give authority to vblele W Uecel lho Provision of any ad or stare at local lawmguNlinn ronsni Ilion <br />Tbel l em aulhn 1 41 In ovmu el lhl ne In perform the work for whkh npplrcalion h m:ele and l rnmpty, wllh the Slate Conlraclors l aw IS 77 RCW and 200.200A WAC. <br />Owner/Aulharl7ed Agent Signature Dale (Revised I92012) <br />