Laserfiche WebLink
. "PERMIT APPLICATICO <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: RMIT# <br /> 17 S c �e i r PR ei 47 oo �.��� V Ir D5„®®, <br /> LEGAL fornewconstruction: Short Plat/subdivision ! 'IharaS *2. Lot No23 (attach copy of long legal description) <br /> OWNER Y"1A _l. Lyit) L®(.,O' Phone/E-mail <br /> Address 3 II . 25-11, Ave 3 City/State/Zip -/e. eq l'J4r— "(2f 2_0a <br /> APPLICANT: Owner —Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent fr <br /> om the <br /> owner to dp work In the space) <br /> CONTRACTOR VA{Z{�c IS , CNhS`lirw C11(Y\ v4State Lic.#p 04 [)c I CM Lic.# 1 II' s • <br /> WO-'1G4- I l I I <br /> Address NIS-II N e[,$, ST:X33( lit ti f 6.. qv)2. 7 Phone/Email HO LH ( VIST 10 to 115n)• (GP^ <br /> • ` : 1 ` ` • r4 CO TACT FQR PEWIT_ <br /> KEZvCo• Soo-G'55(4o <br /> �-i,�-1414 4 <br /> Phone/E-mail (4o(1c71.)I f I f®CO ''t S t- • C-Gv-,-,. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 17 9,t Lic7, <br /> Existing Use of Building ST Rn • HEAT SOURCE: <br /> Proposed Use of Building S r R Gas_ ElectricX Other • <br /> Building type: X 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 /> �Ny 0 tae Pass-,ex cJ .i,-.em12 • _ <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 /> NC—air handling unitsZ. Toilet <br /> Forced air systems I t Bathtub <br /> . Gas piping 2. Lavatory(wash basin). <br /> Ret Water heater I I Shower <br /> . Gas fireplace / Kitchen sink&disposal <br /> Gas range ' j Dishwasher <br /> _ r Clothes dryer / Clothes washer V <br /> / Range hood I Water heater <br /> 3 Exhaust fan I Sink(service/bar/mop/etc.) . <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal _ <br /> Boiler Drinking Fountain . <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap • <br /> Ducting 1 Roof drains • <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 aut ized by the o' er 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 /> 5-. ---7,Owner/Author t Signature ate (Revised 4/2015) <br />