Laserfiche WebLink
PERMIT ApPUCATIN <br /> Bulk®ING/MECHA��ICALIPLUMF3ING/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: PROPERTYTAXtt ERM T# <br /> LEGAL for new construction: Short Plattsubdivision Lot No, (attach copy of Ibng legal description) <br /> OWNER vl�l(/I�n�L/ /0`J Phone/E-mail 2j�� 25D'-107ry 7 <br /> Address 331`? toMA, City/state/zip WA <br /> APPLICANT: Owner _Owner's Agent _Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR E V Cr,;,C,,0CC-tA -�:$ZPCt-C �&r(14VDJ(_ State Lic,# � ` �Z�O� City Bus. Lic.# 0o-Iej5z <br /> Address 'Z1'"Zv q o D I Phone/Email 4 <br /> TENANT l9USIffn%MME CONTACT FOR PERMIT <br /> Phone/E-mail K zy -Z�Z'3�yy <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building D � Gases Electric Other <br /> Building type: ^Single Family _Duplex_Townhouse —Multi-Family Commercial <br /> Type of project: _New _Addition —Remodel X,Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional s ace provided on the back): <br /> /hyo/ac` v l /l.Z2 PJ, , �/Qv, ,�r s,mr►� G�o�ca+ �- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration X Repair Type of Project: _,New_Addn —Alteration*Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping 1_avatory(wash basin). <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc,) <br /> Heat pump Backflow Ore.venter(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRfESS10n 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 complied <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 am au orized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br /> (Revised 4/2015) <br /> ,Q"TrvMuthoriz Agent Signature Date <br />