Laserfiche WebLink
� • <br /> PERMIT APPLICATION <br /> BUILD19VGfMiECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVEP;ETT 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: �O� �jo'f'{� � � �,� /r PROPERN TAX ft P �MI <br /> � P ''� U3 3S Dc�no (g6 � t�1 -�_� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER � Q,h/1(`S I'1 P�ne/E-mail S7o�Q.�nn c`$. C C�� /� Q �I�00 -Cor'^ <br /> Address �jiQ� al�'—� Ll�' -e$� City/State/Zip ��/�J'(.�' �� ��ab3 <br /> APPLICANT:_Gwner _Owner's Agent _Contractor _Contractor�5 A9211f _T@I12tlf(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR � " L& I Lic.# COE Bus. Lic. # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT gs�� <br /> �?mnt'S CO��(� �f�S 3�°� ' <br /> Phone/E-mail nI�(`S.�0� h Q ��()0, Q� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building • �• R• HEAT SOURCE: <br /> Proposed Use of Building S• ('• 1�. Gas� Electric other <br /> Buiiding type: 1C Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New �Addition Remodel Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �he S���Y Q���'�c`�r t.�/ daY lr y��' A�StI'h2n�' �= L�nV�e��e� �t �a.�` �D,,, �� <br /> q �hti n 4:n �h 2 S l��2/ L1 r7a r '�'�7 H <br /> �'�`� �Q¢,� ���aWl5�C2 �!� `�'O ���J,'.�J �e,��,� y y �..�,/ � �fre�n:l+G� � <br /> � W t.�o� t;n 2- H/.n.t� y'� <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(#J of fixfures <br /> � A/C–air handling units Toilet <br /> ( I Forced air systems ' Bathtub <br /> Gas piping 1 Lavatory(wash basin) <br /> ' Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range t Dishwasher <br /> ( Clothes dryer � j Clothes washer <br /> � Range hood � Water heater <br /> Exhaust fan ; Sink(service/bar/mopletc.) <br /> Heat pump j Backflow preventer <br /> � Unit heater I Urinal <br /> Boiler i Drinking Fountain <br /> ; Refrigeration j Floor drain <br /> Woodstove ! Grease trap <br /> � Ducting Roof drains <br /> � Other '�•. . �e ;�il,r' � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> � Number of Heads i Other: <br /> I hereby ceRify 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 /> 1 I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> 1 <br /> ��.v_. �- �'� �7 (`�' i�" <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br />