Laserfiche WebLink
PES' 1\1T /kPPUUCAT11 <br /> BULLD NG/MECHA IICAL/PL U B1NGISIGN/SPR N KER/DE •UUT ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> • y o, /s <br /> SITE ADDRESS: y it PROPERTY TAX# PFt�nmr�e <br /> h Ever-,,AEver-,,A 04 .A O03C'/`3'0O/0Z.7O0 • (5i0-O <br /> LEGAL.for new construction: Short Plat/subdivision Lot No. (attach copy of`long legal description) <br /> • <br /> OWNER .A e I vvei-- 1S�u 'o,%A Phone/E-mail KU lace a‘e k o vv 1) CO vv\ . . <br /> Address p City/State/Zip � �-� (/1/ 9gZD <br /> APPLICANT: Owner kr-Owner's Agent Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR5E4f 7C c: l�L �LPP J 1��1 f^vd/GCC tate Lie,# S*TT }s 52 C City Bus. Lic.# <br /> 7x ' ^ ! �2r/T/-6/t`t//SD✓Cf 114---C� H/j77C <br /> Address ��.� (30 - �• Se f�'� �gt/�`�•!- '�/C' �Ig�� IPhone/Email <br /> TENANT-B-USINESS NAME ' —— 1 CONTACT FOR PERMIT Motket— fe[Mi-r2 <br /> i 1 15516 5-6141.Ave, w i o,r.4,-; wA - %gOz6 <br /> ►"aher-Vefr ,- 6-oka4) ,Cow. g,Phone/Email.Ls S0 - /-f c ' H G , c o ' <br /> BUILDING PERMIT APPLICATION • CONTRACT PRICE OF WORK 169/ '71691.- W4oj <br /> Existing Use of Building V a v,k-- \ki/s:)s-e. HEAT SOURCE: _ <br /> Proposed Use o =' Gas_- Electric Other <br /> • <br /> Building tyie: Single Family,_Duplex Townhouse _Multi-Family ._.Commercial <br /> Type of proje . 'yew Addition _Remodel Repair—T.l._Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <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 /> NC-air handling units -3Toilet <br /> . Forced air systems 1 Bathtub ' <br /> Gas piping '-. lavatory(wash basin). <br /> i Water heater. I Shower <br /> J Gas fireplace ( Kitchen sink&disposal <br /> Gas range ( Dishwasher <br /> I Clothes dryer 1 Clothes washer <br /> i Range hood Water heater <br /> Exhaust fan 1 Sink(service/bar/mop/etc.) <br /> Heat pump <br /> Backtiovr preventef(inside bldg) <br /> Unit heater Urinal , .. <br /> BoilerDrinking Fountain <br /> { Refrigeration Floor drain <br /> Woodstove Grease trap <br /> • <br /> I Ducting i Roof drains <br /> Other Medical Gas <br /> I. <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 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 owner of this property to perform the work for which applicationliis made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAG. <br /> ti&L___:. <br /> owner/Author'--•'A gent Signature a Date (Revised 4/2095) <br />