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 /> 0°2- <br /> (SITE ADDRESS: IPROPERW T X# PERMIT# <br /> r 1 111-1( 1 s t�ilrtictl L.Co leo I I W2 2 'Li0-f <br /> LEGAL for new construction: Short Plat/subdivisionviLot No. (attach copy of long legal description) <br /> OWNER E N( 2E 4 1 Ll.V Phone/E-mail 3‘D cry—ygo <br /> Address 19 dtl A) uY I W II f City/State/Zip 9 bidDliilsi, k AL i f re <br /> APPLICANT:_Owner 1 Owners Agent —Contractor Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1-Avita t */ 1)'u4Lr rb State Lic.# jC£61'Doo V' City Bus.Lic.# 1011c <br /> Address j� uY t ( •�q�1 <br /> U A pi cit4itimita...- 1'hone/Email �p �V <br /> TENANT 1.10 <br /> tJ (NESS NAME I CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of BuildingHEAT SOURCE: <br /> Proposed Use of Building S FIS. Gas X 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 /> Q c' vr ,- - <br /> 6 -(, 4? > <br /> . Le I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project:.XNew _Alteration_Repair Type of Project: _New Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units 3 Toilet <br /> I Forced air systems 3 Bathtub <br /> 2- Gas piping 3 Lavatory(wash basin) <br /> Water heater 3 Shower <br /> I Gas fireplace I Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer I Clothes washer <br /> I Range hood I Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> 0 Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting 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 comp! <br /> with whether specified he 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 n <br /> That I am authorized by the ner of this property to perform the work for which ppln is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. ,,� <br /> d- 31 <br /> Owner/Authorized Agent g ture Date (Revised 9/201Ci_ia <br />