Laserfiche WebLink
/' / � � <br /> PERMIT N►PPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLERlDEMOLIT iON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,W A 98201 -425-257-8810—F�VC 425-257-8857—wuvw.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SRE ADDRES3: Pppq�gq0T�00900 RMIT <br /> 4512 Forest Dr. _ 3 <br /> LEGAL tor new consliucNon: SMrt PlaVsubdivision Lol No._._ (eUach copy of brg legal deunptio�) <br /> OWNER Our Saviors L�itheran Church pionelE�mail <br /> Address PO Hox 2927 City/StatdZip Everett, WA 90213 <br /> CONTRACTOR Te� ca issuance L 61 Lic.# <br /> Addrvss PhonalEmail <br /> TENIlNT BUSINESS NAME NT T F R P M ec y To , <br /> AT&T Mobility Z06-`�0-1793, btodd�ptewa.com <br /> PhonelE-mail <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORKS15,000.00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use o(Building Gas Elec�ic Othar <br /> Building rype: _Stry�e Famlly _Duplex_TownMuse _Multi-Family X Cammerdal <br /> Type ot projecl: _New _AddiUon X Remodel _Repair_T.I._Sign_Sprinkler_Demolitbn_Change of Use <br /> DesCripti0n of Work(edditional spxe piovided on the back/: <br /> Replace antennas at existing wixzless facility ccllocated on SnoPUD utility pole; add cabinet to <br /> existing fenced lease area. Add diplexers. <br /> Have you started workinp without a permlt7 _YES X NO <br /> MECHANICAL PERMIT APPLICATION PLUMBIN6 PERMIT APPLICATION <br /> Typa of ProJeet: _New_Addn _AlNratlon_Repalr Type of Projeet: _N�w_Addn _Altantlon_R�palr <br /> SMw Num6w W RxNres Slaw NumWr oI flxturos <br /> AIC—airhandli units Toilet <br /> Forced air s stems Bathtub <br /> Gas i � Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis sal <br /> Gas ra e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaustfan Sink service/bar/mo etc. <br /> Heat um Backflow eventer <br /> Unit heater Urinal <br /> Boiler Drink( Fountain <br /> Refri eralion Floor drein <br /> Woodstove Grease Ua <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> I hereby certify ihat I have read aM ezamined this applicalion and know the same to be Wa and wrtect.All provisions of laws an0 ortfinances govemlrq <br /> this typa of vrork will be complied wilh whether specified herein or not.The granting o(a permit does rrot presume to give aulMrity to violale or caneel <br /> the provision ot any olher state or local law regulating construction or the peAortnance o(consirueUon.That I am authorized by the ovmer of this property <br /> to pedortn t v.ork tor wfiich applicalion is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200 WAC <br /> �n.. . -/� ����l2 <br /> Owner Authodzad A �n nature Date (Revised7/ZO11J <br /> `la <br />