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 AD E S• 90.cb PROPERTY TAX# P RMI <br /> O�'3 w CASINO Eu r rib 3 rJOS-0(5 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 1316n t 4& c' U`�p R Phone/E-mail <br /> Address P© M 1t 3101 N I J "�-5 City/State/Zip currrLE., WA 471112.1.-220 <br /> APPLICANT: ')t 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 SI! MS"Kit State Lic.# S'K/Ing Sda5 RT City Bus. Lic.# 6443' 9 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> _ACK D( A`l E2 4 A5-23I-©It'8 <br /> Phone/E-mail ,AEAricevi. G• {pgkieL a IzziJ6 M <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK # 3S-01 Odd <br /> Existing Use of Building MFG HEAT SOURCE: <br /> Proposed Use of Building M Gas_ Electric Other <br /> Building type: Single Family Duplex_Townhouse Multi-Family Y Commercial <br /> Type of project: New _Addition 'it-•Remodel _Repair_T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): a Darnio no jonleij 4/JC.911 <br /> A-DD "M111URX- Y13wulri PUP7PS cov of ?7 t, e)//SrmiCPUr7P 19-00/m °116sll E <br /> F01111471 Pum, dJfs'rs1A,E fd-n B[. <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 /> A/C—air handling units_ Toilet <br /> Forced air systems ' Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater I Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration . : <br /> _ <br /> Woodstove _. ..- <br /> Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <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 application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> S-A/15— <br /> Owneutd Agent nature Date <br /> (Revised 3/2013) <br />