Laserfiche WebLink
i <br /> ERMIT 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: l -d'^r W 1 ' PROPERTY TAX# PERMIT# <br /> f I c 1$c�0009c\o '« 1® -©z5 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Seg til/ C,4- `c L.'r 3C Phone/E-mail [ p <br /> Address pep #. /5 St. City/State/Zip T�� / 4 48'11J✓ <br /> APPLICANT:_Owner _Owner's Agent 4_Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR lic,ce NUFt,11nJo State Lic.#WOLFE IDJ..o33 C-j- City Bus.Lic.#o3a6-i 0 <br /> Address 173, ) ,le Si S . St A�nrce_.i W� eigpa Phone/Email "36)(` 'N' 8641 1 <br /> 4 <br /> <Lt0 <br /> Wt <br /> wt6�i C..Corh <br /> TENANT BUSINESS'NAME CONTACT FOR PERMIT LI'A S <br /> tdVWI read f ga.s- 369(' <br /> Phone/E-mail ta(e_ccg) IcQ 3NIn✓ r\�-(6Y‘BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK etc'=' <br /> Existing <br /> Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ ElectricOther <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): 4 Ar& 5,,,k it e P'f 5f t 3116,0„61,1„3, <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 I 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(inside bldg) <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 /> 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 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 a ownerof thi p party 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 /> .e......r <br /> s rel iii? / <br /> Owner/Auth ed Agent Signature / ate t(Revised 4/2015) <br />