Laserfiche WebLink
�ERMIT 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: PROPERTY TAX# PERMIT# <br /> Zy�,� ��la.e.r ,�ve,. E�a�t.'� A. l.o I Oos��--155 ya1 ?.00 � --�L� <br /> LEGAL for new construction: Short Plat/subdivision �d����� �� �l�- �Lot No.l��i'�ttach copy of long legal description) �S �(p <br /> OWNER Jal(e o� �,��+ ; t, �:, �e Phone/E-mail �(?f,-(oiv- WS�t <br /> Address �i`'�3� �V`�,/ �� . City/State/Zip t,,.e,�r- i,,� , qgzo� <br /> APPLICANT:_Owner �Owner's Agent _Contractor _Contractor�S A92flt _T0f1811t(must provide a letter of consent from the owner to do work in ihe space) <br /> CONTRACTOR G�+G✓n�q� orl r Vc��oh State Lic.# (0�0 l(��a?s I City Bus. Lic.# 13l 00(�9� <br /> Address �pCj� EaQrv(aR�S L.3a E�o�or5 W/� OZp Phone/Email N1,�j — ��(o— /3/0�- <br /> TENANT BUSINESS NAME CONTACT FO PERMIT <br /> ,y/ /La be,� �i1?o �r.� �-'�vS�c_ <br /> /��a5e�ic �eM p�- Phone/E-mail L(z�- - CjOo /fil� !L� <br /> C�1 i�2 inS'.4ra <br /> / <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK D OOo <br /> Existing Use of Building /��i�ioVS �Q'cj�i v j�-}e$ HEAT SOURCE: <br /> p � ( � . <br /> Proposed Use of Building /�-e�/�✓S �C1�'� 1�/die5 Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �G Commercial <br /> T e of ro'ect: New Addition �Remodel Repair T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> � <br /> /Le�inv�e/ p�o in�e•-;vr- a¢ bvi Id;�� . jZPn�cov�y/ o� ����s w�!!S a,• <br /> aoP oP��;a.. Be� �?4Krs 1`- pes ds � �o�:.r y 5 7� SupFb✓d- JCIAs-- 4.�.0.� /bo➢�'� <br /> �o.�fl �f i a ior �b(G�a.T.:.te �e-v�I , <br /> MEC ANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <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/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas pipin Lavato (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> � Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mop/etc. <br /> Heat pump Backflow preventer(inside bld ) <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease trap <br /> Ductin 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 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 specifed 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 am authorized by the 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 /> G�-- �b l�' ; ��z <br /> O ner/ ized Agent Signature Date (Revised 4/2DY5)' <br />