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 ADDRESS: , PROPERTY TAX# PERMIT# <br /> 10 VItrrI1� Prv_ (71Sq)3-02- I M1111- 3 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER £+tIO(k i1rt?stAR Phone/E-mail t tt <br /> ) /lc '3"- VS--- <br /> Address <br /> c <br /> Address atti,b Yl'r '',n /a_ __ City/State/Zip f u.e,i-d-f-L w qtaoi <br /> APPLICANT:_Owner _!Owner's Agent Contractor _Contractor's ,• _T,enant(must provide a letter of consent from ttre owns do work in the --.- <br /> CONTRACTOR i j Nseas`n , to C_ Sta e Lic.# K +*t) City Bus.Lic.# 0 ` <br /> Address (4 �+i,4'L! 5u6, U I.1-C. C., r i^ one mail ". ' — I <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> (Yli clot e(a Q O le-ts n - TNN T1-l6freS6 <br /> Phone/E-mail (fig) q(t s=�31 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK gi 600 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gases Electric Other <br /> Building type: >CSingle Family Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New —Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> fitela44.6 DO flIOWt, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn AlterationKRepair Type of Project: _-New Addn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove 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 applicatio.and know the same to be true and correct.All provisions of laws and ordinances governing this type of work wit be comp) <br /> withw- ther .cified he,. or no The g�,.I ing o p- Idoe of presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That - au orized by owns o this.l'j•.e th ork for which application is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> 0 I- • ' e• i n•t = Date (Revised 9/2014) <br />