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 /> SITE AnnpFSS: PROPERTY TAX# PER T <br /> � , " L�� i�' �_U0 ) <br /> LEGAL for new construction: Short PlaUsubdivisiorl�J�SCACj�► ` ��--� Lot No.�� (attach copy of long legal description} <br /> OWNEF�r;A.,,('«..� }�Cw — \C� ��y/t��s. Phone/E-mai1�4Z5� �"lS � � Z'�v E_'sG <br /> Address iZC S�v �V�G�cT Wv`��. l,�,w ' CityfState/Zip G�;�z'.��-� bv'�r� , G�;�Z.�R <br /> APPUCANT:_Owner _Owner'sAgent _Contractor _Contractor�SA9@flt _T@fl8flt(mustprovidealetterofconseMfromtheownertodowoikinthespace) <br /> CONTRACTOR �/4►T�. �C�.�.-��—:�--� State Lic. J��iA���CGS�� City Bus. Lic.#( d� -Z{�lF�- 3� <br /> Address S b.Vti4Z PhonelEmail Sf��N�, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT,�,t� ������ <br /> Phone/E-maii C''{Z-S, �S�' " ���'�— <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK���T� L� _ �`�' <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 /> T pe of project: '�New Addition Remodel Repair�T.I.�Sign�Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(addrtionaf space provided on the back): � <br /> { l_�,�� � �i'�. �-�/�A�=i� ��1��J t L.,_,.> � V C��+� <br /> 1 ��]j � Vt0uS2 �72 �QYQgG <br /> MECHANICAL PERMIT APPLICATION P�UMBING PERMIT APPLICATION <br /> Type of ProJect: !7New_Add� _Alteration_Repair Type of Project: ✓New_Addn _Alteration_Repair <br /> Show Number(#J of fiztures Show Number(#)of fixtures <br /> � A/C-air handling units � � Toilet <br /> � � Forced air systems �Z Bathtub <br /> i Gas iping � � Lavatory(wash basin) <br /> Water heater { Shower <br /> � Gas fireplace I Kitchen sink&disposal <br /> I Gas range i � Dishwasher <br /> � Clothes dryer � Clothes washer <br /> I ; Range hood � i Water heater <br /> t jj i Exhaust fan \ � Sink(service/bar/mop/etc.) <br /> � Heat pump -�-- i Backflow preventer <br /> j Unit heater Urinal <br /> -� 4 Boiler -�- Drinking Fountain <br /> � i Refrigeration -- Floor drain <br /> I Woodstove �- Grease trap <br /> � Ducting Roof drains <br /> � Other Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM —. I Other: <br /> Number of Heads �' Other: <br /> 1 hereby ce�tify that I have read and examined this applicalion and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether spec�ed herein or not.The granting of a permit daes not presume to give authority to violate or cancel the provision ot any olher state or local law reguleting construcfron <br /> That I a T� uth rize t owner of this proparty to paRorm the work for which application is made and 1 comply with the State Contractors Law 1 B.27 RC W and 296.200A WAC. <br /> � � 2`1 - l �{ <br /> Ow� r/Authorized Agent Sig�ature Date (Revised 3/2013) <br />