Laserfiche WebLink
PERti���#8T' PPS.UCAT <br /> . • <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> (1 i.t/2' OF l S <br /> SITE ADDRESS: .1 s PROPERTY TAX# pFtznnrrIe <br /> oo35c20 l'fo Z?o 0 i i O OP-9 <br /> 1•i/%3k,ve `3 pL; Eves-- t i� _ �-O.�'. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long`legal description) <br /> OWNER A te+ Ku 'lit-�a Phone/E-mail VU1a-. e�.0, ifk0+V> t l.COvv\ . . .. <br /> Address '20 S r.,01A, S4 SE (A? f1 4 City/State/Zip - erel\ • (ij A 5/162 cog <br /> APPLICANT: Owner AZ-Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTORS:C4%1-e / Qi'1 Iforj fav State LIc.# s'ekTT--54 S 82 C./ City Bus. Lic.# <br /> 7-� `Phone/Email f r/�/-6�t 0//$D4 M S ���L, <br /> Address r .r (3, �;. ,ca it 4 e--y `� ( `wk 'k I <br /> TENANT BUSINESS NAME _- —--1 I - CONTACT FOR PERMIT Mo0Ae_ eLpi.c . <br /> 15516 5-64( Ave. IN -wl0v14f: WA- 9s 02,4 <br /> Mahe-Nett h:,- 6-Motet) .C�' vin :.«Phone/E-mail.Vs 50 „ /I&-' 1 ,-M, f , e....0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 05e)/ g'71-1.ea.. hal <br /> Existing Use of Building_V acs v\k W.ig.D3-c HEAT SOURCE: <br /> Proposed Use o : Gas_ Electric Other_. <br /> Building ty'e: )( Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of prole . _ `ew _._Addition —Remodel _Repair_T.1. 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 fixturesShow Number(#)of fixtures <br /> A/C-air handling units - I Toilet <br /> . Forced air systems ( Bathtub <br /> Gas piping 4. Lavatory(wash basin). <br /> 1 I Water heater. 1 1 Shower <br /> - .I Gas fireplace ( Kitchen sink&disposal _ <br /> Gas range • ( Dishwasher <br /> I Clothes dryer 1 Clothes washer <br /> • Range hood Water heater <br /> Lj� I Exhaust fan ) Sink(service/bar/mop/etc.) - • <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> ( BoilerDrinking Fountain <br /> { Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> 1 Ducting ( Roof drains • • <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: ,. , <br /> I herepy 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 application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> g/7/ c ` <br /> wunerlAuthor'-- 'Agent Signature <br /> Date (Revised 4/2015) <br /> • \ 1,' <br />