Laserfiche WebLink
OCT/31/2016/MONjj}}(( [[ r11�:'5i3 jA/�M Gree- ..d Heating <br /> ,^ . FAX No, 206 46.`. 216 P. 001 <br /> leo Cult I uli` ` 5 II,I, t ,ie �/, <br /> ( 0)4(Da_Coa15 PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-2578810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM • <br /> SITE A s s ..S: PROPERTY TAX# l'C <br /> - <br /> 947A • \\� kw.,1 Eska• WA qS c ri.©DMI S % (o — c <br /> LEGAL for new construction; Short Plat/subdivision Lot No. (attachtalcopy of <br /> long legal description) <br /> OWNER VWN1'CJR)►�f�1e, tJ� -1. Phone/E-mail (2c( �' i-- `16"1 <br /> Address 42A .icy Ike , 1Nic City/State/Zip e vexem., c <br /> APPLICANT: Owner _Owner's Agent contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ��( )n Lk V3 SA L&I Lic.# I EI4 H c`2.k3-1 COE Bus. Lic.#0459 6r <br /> Address ),..`J Skiazi sT s20,442_ (ec. CL t \ Phone/Email (2.1icrV4v– <br /> TENANT BUSINESS NAME CONTACTR twle_YC <br /> k0 Gm <br /> phone/E-mail L.. o" LL� ne 4al-o) <br /> , Gn <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building_ GesX 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 beck): <br /> 1xfAa \ \e �ev LAxkA-R.N \a . <br /> cxx6eAlts ell..2M V-75 T v(tut Ie.Tt,t Svm,r+'( <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn Alteration_Repair Type of Project; _NewAddn _Alteration Repair <br /> ` <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC–air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> I 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/tsar/rnop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> I Boiler Drinking Fountain <br /> Refrigeration "- <br /> Floor drain <br /> Woodstove Grease trap <br /> Ducting W 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 wHi be compried <br /> with whether specified herein or not.The granting of a permit doss 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 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 /> '/ <br /> Owner/ uthorized Agent Signature Date (Revised 6/2012) <br />