Laserfiche WebLink
FEB/09/2017/THU 03. 52 PM North Creek Roofing FAX No, 425 487 6524 P, 002 <br /> PERMIT APPLICATION <br /> BUILDING/MEC HANICAL/PLUMBIN GISIGN/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:5SC, r &VCr( Glvu- / qG z�2 pRO77TAX# P <br /> LEGAL for new construction: Short Plat/subdivision b J Lot No._ (attach copy of long legal description) <br /> OWNER v-W{n NJI T7 w-- Phone/E-mail Z G-Q) — -^`(�0—+ <br /> Address city/5tatef4p <br /> APPLICANT:—Owner <br /> —ownerr's�A4gent l Contractor _Contractor's Agent _Tanant(must crovtde q latter of wowrlt mom the ownerto do work in the space) <br /> GONTRAC\TOR �`��i Lr�kfStA [Z�1 �' 1,V`���A L&1 Lia#��S �i(` a0 c+C�OEE Bus.Lic_ <br /> Address \4.�3u) �� V��9 Y�lv' `�1Z V"��� L Phone/Email ^"U•4 0 �p <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT c��r;n,�C�� <br /> Phone/&rnail `"` �b J 'T-\ b <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK A.L'V, (� �• �� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building ___ Gas_ Electric Other_ <br /> Building type: A9ingle Family _Dupl x_F'ownhouse _Multi-Family _Commercial <br /> TyRe of Co act: New Addition XRemodel Repair T.I. Sign_Sprinkler_Demolition_Chan a of Use <br /> DESCRIPTION <br /> �+O�+F WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New__Addn ___Alteration_Repair Type or Project_ ---Jew_„_Addn <br /> M,,,AlferaIlotl—Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forged airs stems Bathtub <br /> Gas piping Lavatory(wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/barlmo lett. <br /> Heat pump ( Backfiow preventer <br /> ( Unit heater ( Urinal <br /> Boiler Drinking Fountain <br /> Refri eration <br /> ( Floor drain <br /> k Woodstove ( Grease trap <br /> Ducting 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 appticebon and know the same to be true and correct.All provisions or laws and ordinances governing this type or wort:wit be complied <br /> AM whether specified herein or not.The granting of a parrnA does not presume to give authority(o violate ar cancel the provision of any other state orfocal law regulating congtrvd0ri <br /> Trait am authorized by the owrtprof this property to perform the work forwhich applicason Is made and I eompywlth(he S(aea ContCadons Law 18.27 RCW and 295.20DA WAC. <br /> 02 0 r 20 [ <br /> erlAut orizsd Agen Signaturo Date (Revised 8/2012) <br />