Laserfiche WebLink
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 /> SITE ADDRESS: 2_0k11 fote sePROPERTY TAX# IT# <br /> iqt:54--I* t <br /> LEGAL for new construction: Short Plat/subdivision M V t nti "`-!1 Y t-s Lot NoF2/., (attach copy of long legal description) <br /> OWNER Secktm RAI - c t.....1 o e S Phone/E-mail 1426 ti.T2-) 2g0 <br /> Address 1'2Q heti) —ve ; - ktkvic 4 _N i 0(2 City/State/Zip ( ,H. q 20—i <br /> --. -—.l <br /> APPLICANT:_Owner Owner's Agent A Contractor _Contractor's Agent _Tenant(must provide a letter of consent from owner to do work in the space) <br /> CONTRACTOR MO adj j(,,13 %j• �'j' 1 0 State Lic.# 'PA)a�d� i� City :us.Lic.# a. Z t j <br /> r v <br /> Address 9 !`')(Gy.,tor.j '' ,s i Ile ID t _� 0I,od i Sh i in/Y4 Phone/Email .J�i5 3`a ? 5-) - _ . <br /> TENANT BUSINESS NAME-__ CONTACT FOR PERMIT _ <br /> -"--`"�-...,_ Phone/E-mail 426 V4 R — 5 100 . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OFWORK $ ( pi P. O <br /> Existing Use of Building HEAT SOURCE: • <br /> Proposed Use of Building 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): C. L2-0(0 <br /> rnu(-11 -- out --(i(LQ-- 5citeet-- -"s1611 <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 /> A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range 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 Grease trap , <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRIN LER/SUPPRESSION SYSTEM Other: <br /> 2 Number of Heads Other: <br /> hereby certify tha 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 wit be compl <br /> ith whether s ified 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 /> -t I am a Prized by the owner f 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 /> Owne •ithorized Agent S nature : -" Date `(Revised <br /> - - 9/209 <br /> ...,;yg;t. . _, g t.� k . .! .+Sss- <br />