Laserfiche WebLink
puget heating 4253978762 p.1 <br /> 0 <br /> 0 <br /> 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—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: ,— <br /> -! �� ` ���1P/�Y O //_ PROPERTY TAX#— <br /> I yPEER�MIT# <br /> LEGAL for new construction: Short plat/subdivision ` • ,��062-��`'' <br /> ,,//�� <br /> Lot No. {attach copy of Tong legal description) <br /> OWNER or/ '1") /1/2e742).`LJf S <br /> I Phone/E-mail <br /> Address az) 6�c�d� ,-y i„,z,„)7)_11 City/State/Zip <br /> CONTRACTOR j1/ Q 71 /� ,�J �y I <br /> Address �Q� � ' ZLL /��,,,�^ 1--7373 ,/� <br /> �✓ /� �� S L Elm( % s�:� 'Phone/Emelt �yC�JGS5� �/ / <br /> TENANT BUSINESS NAME <br /> CONTACT FOR PERMIT <br /> 4 ° 7L v 7.<, ,, l��.�'GU ,A.7---1Ci er ' / /n t�= %-n e a- <br /> BUILDING PERMIT APPLICATION Ph011B�-"'ail .../`_ S'..3s^4,f/'/// <br /> CONTRACT PRICE OF WORT{ f t� <br /> Existing Use of Building -�J,Dlyra 2?y-t <br /> Proposed Use of Suildin HEAT SOURCE: <br /> g -5t YY7 <br /> Single FamilyGas Electric Other <br /> Building type: Sin <br /> 9 Duplex Townhouse Multi-Family V--Commercial <br /> Type of project New Addition 17Z7noclel Repair T.I._Sign Sprinkler Demolition Change of Use <br /> Description of Work(erica/oriel space provided on the back): <br /> le.e.1 fe_ —_, -71-1,y17a1� Z2C.!' -2/1 GvCl It"G/r---) C%J!i el .676--)l/J 'i e--'(7err1-7 / d/` <br /> Have you started working without a permit? YES �J <br /> 1�N0 j <br /> MECKAN{CAL PERMIT APPLICATION I <br /> PLUMBING PERMIT APPLICATION <br /> Type of Projecj, NewAddn Alteration Repair Type of Project: New Addn Alteration <br /> ShowNumber 4Yy of fixturesRepair <br /> NC—air handlin• units I Show Number(11 of fixtures <br /> Forced air s tems I Toilet <br /> Gas pi•in• Bathtub <br /> ( Lavato wash basin <br /> IIIIIIII"IMMIIIIIIGas fin=_.lace I Shower <br /> ._ Kitchen sink&dis•osai <br /> Clothes d r Dishwasher <br /> Ran.a hood i Clothes washer <br /> ` Water heater <br /> Hea# • Sink(service/bar/mop/etc.) <br /> Unit heater I Backflow preventer <br /> Boiler <br /> Ref"aeration Dunkin• Fountain <br /> Woodstove I• Floor drain <br /> iniumminummarmin <br /> Ductin• <br /> Other I Roof drains <br /> SPRINKLER I SUPPRESSION SYSTEM Medical Gas <br /> Other: <br /> I Number of Heads <br /> Other <br /> I hereby certify that I have read and <br /> examined this application and know the same to be true and correct Ati provisions of laws and ordinances governing <br /> this type of work will be complied with whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by <br /> to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCROA/and 296.200 WACthe owner of this property <br /> '1/ %/.,. ,�-2 p� i'`� <br /> • . edAuthorized Agent Signature -6"// i., ,A <br /> D i <br /> (Revised 2/2011) <br />