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 www.everettwa.org <br /> SITE ADDRESS: G 4 c>�> lmi ",� 12 J I-L c /,� , p��w PROPERTY TAX# <br /> '?3 I'lG P RMIT# <br /> r� 3 <br /> i <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> OWNER ' `✓< G.v r t '_ <br /> i Tii" cze X v' J L 4 Phone/E-mail <br /> Address �{ �- <br /> City/StatefZiP ,, , <; �• '` <br /> APPLICANT:—owner _Owner's Agent -KContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR [ jl (J:(�JaPrts' LJOrS', lvvc State Lic.# l" :-'�'.i �.; '_ <br /> y City Bus. Llc # n <br /> Address J Sc 2 SS i. �,i r;:•�.• <br /> ``li• f. r. 'cam�'Z Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Fee- <br /> 1JC C, <br /> _ Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ / <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type ofproject: New Addition Remodel .` Repair—T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> (` L T r s r C <br /> Z., J. )`j Lt r-% <'�/`Lc� �' � �' f / <br /> 4'."c' f /yt rc Ilei-i <br /> qqi-e ellw,�i Z etc+ rj c'� �/d /S rcl+ ar rLc . C' 7�11cv /�S/ CO.vc_.^ttZ' � a� Pi'triN=r��'c� <br /> CtJ^aazf iN/S j <br /> �I�nk MECHANICAL PERMIT APPLICATION ' PLUMBING PERMIT APPLICATION <br /> k <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number #)of fixtures <br /> A int A/C—air handling units —77-77— Toilet <br /> Forced airs stems Bathtub <br /> Gas pipingl Lavato wash basin <br /> Water heater Shower <br /> Gas fireplace ! Kitchen sink&disposal <br /> ( Gas range / Dishwasher <br /> Clothes dryer 11 Clothes washer <br /> 1 <br /> Range hood i Water heater <br /> Exhaust fan ; Sink(service/bar/mop/etc.) <br /> Heatum� 1 Backflow reventer inside bldg) <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration <br /> Floor drain <br /> Woodstove Grease trap <br /> DuctingRoof drains <br /> Other Medical Gas <br /> 1 SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp) <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I a;1authorized by ft owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ' r <br /> Owner/Authorized Agent Signature ' v��9 <br /> / (Revised 4/2015) <br /> )IZ <br />