Laserfiche WebLink
• <br /> PERMIT APPLICATIO <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# PERMIT <br /> 2.000 7bWER. SMeiCT: 009/9Kl ALL & I , f)I 'O I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER E0f.C-T COftV ,'6T7 -/ <br /> yE) Co 41-.6-616- Phone/E-mail 1/25" •5ft, -/o`3I <br /> Address Z 000 T f v0/- 57(2e& - City/State/Zip Et''./-&t7- /iii4 <br /> 1 <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 <br /> QQ p n r_t ��� State Lic.# City Bus. Lic. # <br /> .B <br /> Address 1. evt , vv Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 206..6,.q 2717 JQ,,fresvrs ,ft'�•e.,,,^'► <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK it/761 ()Qty <br /> Existing Use of Building DFft'i / 40j42/A) HEAT SOURCE: <br /> Proposed Use of Building 63.1F/97 if/ 1-0/7!//22 Gas Electric Other <br /> Building type: 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 /> / pt✓ctc5 G/t,Tny Dc 4. /•v ,k, <br /> n0lJE[ ) 0 j s4 i S v ITE- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Re it <br /> Show Number(#)of fixtures Show Number(#)of fixtures R 64CE' <br /> A/C-air handling units j Toilet <br /> Forced air systems Bathtub <br /> Gas piping f Lavatory(wash basin) <br /> Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater 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 j 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 authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ` ) <br /> /** z-�c <br /> C()r/Au or d Agent Signature Date (Revised 3/2013) <br />