Laserfiche WebLink
S 0 <br /> 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 /> SlqADIRESS: PROPERTY TAX# PliVka, (2- <br /> ,i -DI i.- a..„- 0 r <br /> b L n oc)-4-eg. ce,c1b0 ot3 '30e, <br /> LEGAL for new construction. Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER )2\ r IL. f2_0 cl 4,-c 0 Phone/E-mail 4 49 6 • S5q , <br /> Address ,SOL-9'"" City/State/Zip <br /> APPLICANT: Owner Owner's AgentContractor Contractor's Agent Tenant <br /> irnust rode a soar of consent hem the CANTIV In SO v,, rk in the <br /> CONTRACTOR Sf{Ar -‘ 1 411 -\ if\LI State Lic ft 4,,vy1 kia-1-1 eq City Bus. Lic.# DQ g ''" 0 <br /> Address (0 01 5 1`34-\4' 12 L S1.4441--(- CI 61 to8 Phone/Email -Dte? .,9 LI <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Jt 71,11, • <br /> Phone/E-rnaia.1 YYN1-4-oribf igh,4 •.4 ,./1,41y.4 . CXPYYTh, <br /> BUILDING PERMIT APPLICATIONr,r1 q <br /> CONTRACT PRICE OF WORK /":'$ 0 D. 0, <br /> Existing Use of Building fEAT SOURCE: <br /> AX'''''' <br /> Proposed Use of Building Gas -,-Electric - Other, , <br /> ., <br /> Building type: Single Family Duplex Townhouse Multi-Family Commercial <br /> liptafLEEsiifsiiAqE ,5sidition - -nodel ... Repair-TI. _ §:91.....§2112kler_Demolition _Charige of Use. <br /> DESC IPTION OF WORK(additional space r.eiteided on the back): <br /> p.4. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of PiAect: New Addn Alteration Repair Type of Project: New Addn Alteration Repair <br /> Show Number(ft)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> 1 I Forced air systems Bathtub <br /> Gas loin. Lavatory(wash basin) <br /> V Water heater <br /> Shower <br /> Gas fireplace <br /> Kitchen sink&disposal <br /> Gas range _I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> ., <br /> Ducting i Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> Number of Heads Other. <br /> I hereby caddy that I have read and examined this application and know the same to be true and correct.AU provisions at laws and ordinances governing the type of work will he camp <br /> S whether specified herein or not The granting of a permit does riot presume to give authority to violate or cancel the provision at any other state or local law regulating construction <br /> Tha I am authorized by the own r of this property to perform the work for mirth appli ation is made and I comply with the State Contractors Law 1E127 RCW and 296.200A WAC. <br /> o 1 9 LP Ae <br /> to ner/Authorized Agent Signature ate (Revised 912014) <br />