Laserfiche WebLink
EMIT APPUUCI T1 = <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 /> _- <br /> SITE ADDRES PROPERTY TAX# PERMIT# <br /> ®x/12 l ( o4Dr - 7/ P�t1�- Div <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ' <br /> _ Phone/E-mail a 0 <br /> OWNER / i7/ ( �f��--c.�l`/ 7),4----,01:s) � . ,� � � ... <br /> Address � I ,M O1'*�r r A- • t ( IL-6 City/State/Zip i� i f ‘.y.:_,,.# 9 V / <br /> APPLICANT:✓Owner _Owner's Agent Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lie.# City Bus. Lie.# <br /> Address . Phone/Email <br /> 'TENANT BUSINESS NAME ' CONTACT FOR PERMIT <br /> • Phone/E-mail A„/i/rQ ii ofifays 6 ! UjAi-lie/y) • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORk <br /> Existing Use of Building ,6-r ICIP 74'4 f r HEAT SOURCE <br /> • <br /> Proposed Use of B ' ing d 14- 4c-i4' I c`""e. Gas_ Electric °r Other <br /> Building type: N Single Family _Duplex_Townhouse _Multi-Family ^Commercial <br /> Type of project: _New —Addition _Remodel —Repair—T.I._Sign Sprinkler_Demolition hange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): r <br /> �' --rs rcE c7--/6/Li '�le, /,- A-c 00— �'`/t y `1 <br /> ' #4r7"4-1V1-7-01 '''F 4577.48 $4¢-J' ay Rst-Thf,a aPM r <br /> Vfr Rent' / 47/MI <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 fixturesShow Number(#)of fixtures <br /> NC–air handling units Toilet <br /> • Forced air systems I Bathtub <br /> Gas piping Lavatory(wash basin). <br /> I Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal _ <br /> Gas rangeDishwasher <br /> Clothes dryer - Clothes washer <br /> ' I Range hood Water heater <br /> - I Exhaust fan I Sink(service/bar/mop/etc.) <br /> L Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> I Woodstove I Grease trap <br /> ( Ducting I Roof drains <br /> . I Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM • Other: <br /> Number of Heads Other: .. <br /> • <br /> I hereby certify that I have read and examined this application and know the same fo 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 authorized by the; o,,;; .•roperty 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 /> �1.1 / /2 -(5 ' <br /> Owner/Au • mer e; ge t-t'gnat re Date (Revised 4/2015) <br /> • <br /> 1Z <br />