Laserfiche WebLink
IkERMIT APPLICATIOOO <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# P.ERMI <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER -V_'' nitylf (,SSC'/j 11 Phone/E-mail (0- 1 2,--(p 2.,(a._,i <br /> Address ?)1 l ) Jam" ill-e, S t4) City/State/Zip • / • , 0 8 16(Q <br /> APPLICANT: Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> • <br /> Address Phone/Email <br /> TETUATTTISIAESSTIAM CONTACT FOR PERMIT <br /> p 0 01,1,(A,ti - VA'l'-,) LAX/ Ier1219i l'- I-6)c\Kr) i' I abbot- 2-612-0 <br /> Phone/E-mail (P- ) 2--(0.-2)(0(4 111V-4I.eCritin <br /> • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4-bOo° i.c° <br /> Existing Use of Building ha►afe, .-fA al b HEAT SOURCE: <br /> Proposed Use of Building /2w)6Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse Multi- amily u Commercial <br /> Type of project: New Addition Remodel Rep Ir V T.I:_..2_Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> reivt ) A k, rrt< <br /> MECHANICAL 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 /> j A/C—air handling units ' Toilet <br /> Forced air systems i Bathtub <br /> Gas piping Lavatory (wash basin) <br /> Water heater ! Shower <br /> Gas fireplace Kitchen sink&disposal <br /> I Gas range j Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> j Exhaust fan j Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater I Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove i Grease trap <br /> Ducting Roof drains <br /> Other j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ' <br /> i Other: <br /> 1 <br /> I Number of Heads Other: <br /> I hereby certify that I have read an•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 4 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 oww • this 00177-'- to•erform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> _.%131i---2 Z-i_ 0 Id 0 1. : - <br /> Owner/'u d orized Age Tgna re Da e (Revised 4/2015) <br /> ..\ <br /> ( IL , <br />