Laserfiche WebLink
PER',:61TAPPUUCAT O <br /> J U1LDING/MECCAN1!CAL/PLUMBING/SIGN/SP F1'INKLER/DEME•UATIQN <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 ADDRESS: PROPERTY TAX# PFR"mTit r5 <br /> F I/. _' - -IN oo Zao/0Z.7Oo L 0y <br /> � <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER .Alime+ Ku ta`oa Phone/E-mail kV ICiCei—0,e 14 0+1AA,67,11.CDVv\ . . ... <br /> Address I L <br /> `` 0 12" l S f <br /> hir A� City/State/Zip - r-el•-- (/(W)4 Z vg <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 '1( -v ' - ' furl -in,(.'ac State Lie,# 5e* -b4 S 82 C f City Bus, Lic.# <br /> Phone/Email Z.f V/-64ti/ SOhtf��tst �/yq�l <br /> Address /2c7,T (30 7- c2,-. Se ��i `=v 1 'Lt//r ewZa� l � l � _ --- -----.• <br /> A 1 r - f CONTACT FOR PERMIT -. "iv A )e <br /> 15516 5-6`61 tom. In/ Nvo is tkol- ggov <br /> Maher-Vera,- . 'v s t) .seovt" . Phone/E-mail."4 SU - `-fe 1 Y h,, i.., c., • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 15'1 e7L/.ea. hal <br /> Existing Use of Building V v,k-- \1A-ta.Js-e HEAT SOURCE: <br /> Proposed Use o c s - DasElectric Other <br /> Building ty-e: X'. Single Family -Duplex_Townhouse _Multi-Family Commercial <br /> Type of proje . _ 'ew _Addition _Remodel •,_Repair_T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /)Ek) 5 riq — k7T, d%b <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New^Adds Alteration Repair Type of Project: _•New Addn Alteration_-.Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units "3 Toilet <br /> Forced air systems 1 I Bathtub <br /> Gas piping c'�. Lavatory(wash basin). <br /> I Water heater. 1 I Shower <br /> • , • Gas fireplace ( Kitchen sink&disposal <br /> Gas range . ( Dishwasher , <br /> I Clothes dryer i Clothes washer <br /> • <br /> Range hood Water heater <br /> Exhaust fan <br /> I Sink(service/bar/mop/etc.) • • <br /> Heat pump <br /> Backflow preventer(inside bldg) <br /> Urinal � . <br /> Unit heater - <br /> Boiler1 Drinking Fountain <br /> { Refrigeration Floor drain <br /> Woodstove 1 Grease trap <br /> Ducting 1 Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM _ Other: <br /> Number of Heads Other: ,• , <br /> I hereby certifythat 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 application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> _"---- g`/7(zo rc , <br /> owner/Author-•-. Agent Signature Date (Revised 4/2015) <br />