Laserfiche WebLink
I ERMIT APPLICATIO, <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 /> 7�.7--/5 <br /> SITE ADDRESS: PROPERTY TAX# P Pft# DCA <br /> 2 CI 30 M c�P 1e, Slecec (111A- �(7 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER CD(OJT I-t[F 9.1. Phone/E-mail <br /> Address City/State/Zip <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 CA\tx 6;40 ",,Co State Lic.# (Av.veA c15Q APGCity Bus. Lic.#p k-g[1„1 t <br /> Address V1\ ) . C.'yj. &-J S4 I C. 'kke, WA 18 oR A e, 311 7561 C..._se.. d Q CoIwN,b;a\ ,�C.�Ct <br /> \c <br /> ''''BUSINESS NAME CONTACT FOR PERMIT 1r� <br /> coc�, \--\err Cv M c I <br /> Phone/E-mail J L GAS 6-19GVe,. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 270 f 600.as <br /> Existing Use of Building HEAT SOURCE: <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 /> i.) cl.s.Avel;Kg 3 cle@\c�;v J ca. p-,v,h5 e_,+scs'A. -k-o -V4,c. G.ko SZAvre,TrC,\u .tt brc.)nc'4 V% eS <br /> ave, vvw.;v -r c c hc, blu.GdC gi\ \',. c,. c-, ,vu�S .,V\ ane �c_xK'r' e c ec,.., a cue& , <br /> MECHAN AL PERMIT APPLICATION "-UMBING 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 /> NC–air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> — <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 Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain 1 <br /> Refrigeration Floor drain 1 <br /> Woodstove Grease trap <br /> Ducting Roof drains I <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> 668 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 the owner of th prop 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 . /_ <br /> Ow ed Agent Signature Date (Revicari a/2n15) <br /> 1/ 3 <br />