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: 0 01- .H' CI_ ; PROPERTY TAX# ' V \-O2— , q <br /> LEGAL for new construction: Short Plat/subdivision M VtV M ittAilltS Lot No.V 1 lQ (attach copy of long legal description) <br /> OWNERS f 'l'-+(_- Homes Phone/E-mail Li IS (1,55goc) <br /> Address 120 v,) 'J ,i't o \ 4 i 0D City/State/Zip j.-4(.4A-.. q 4,20 <br /> APPLICANT:_Owner _Owner's Agent X Contractor Contractor's Agent _Tenant(must provide a letter of consent from t, o er to do work in the space) <br /> CONTRACTOR &foxed 0011614PJJ41V''9 State Lic.# A�yN:"Ld1l-/.5 City Bus.Lic.#FSZg I R <br /> Address ! W22. Ai ckford flrtlli,t ik.0, 5Y[)klo 3ichJ/e//4 Phone/Email 1S 314 ? 51 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 1-1/6 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ' P - 6'0 <br /> Existing Use of Building HEA . <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): <br /> a1 <br /> Mit/—11 — (1t3'e- -r/&Q. 51jtPfr <br /> .''''Z''''' � = <br /> 611 <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 <br /> Unit heater <br /> Boiler <br /> Refrigeration <br /> Backflow preventer <br /> Urinal <br /> Drinking Fountain <br /> Floor drain <br /> Woodstove <br /> Ducting <br /> Other <br /> Grease trap <br /> Roof drains <br /> Medical Gas <br /> -PRIN LER/SUPPRESSION SYSTEM Other: <br /> 2.2 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 comp) <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 authorize. .y 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 /> 4------ ice1'7 4 <br /> wner/Authorized Agent Signature S <br /> 1Date (Revised 9/2014) <br />