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PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING I SIGN t SPRINKLER 1 DEMOLITION <br /> CfTV DF EVERETT PERMIT:iERV:DES <br /> 3230 CEDAR 3TR=ET,Ela_REIT.WA 332) <br /> #1111/24'hel`46; <br /> s?)425-25r-3313 1 FAX 423-23T-335T 1E)arra ttapa <br /> Slue:GrY a : 'L►x f•• � www�v rr p rPm-miry <br /> ?RDJE T SITE ADOREaa <br /> LEGAL.to-law. r r PROPERTY TAX fie <br /> ;U..1o`t 3,1il'"]373i60F334n:4W,..:._.,_ <br /> 2 Nie,' ae aci copy cr"'long legal,iwscr:"ofiiunl <br /> pm <br /> OWNER�'`�aLtE° <br /> _ s , TENANT NAME(if C - rrtat'MtaI) <br /> 11111 µ <br /> = >xs>,OWNc2 PHONE; , 1 <br /> 9 \ OWN 4MA(L: <br /> CONTRACTOR NAMF1. '.` ..' <br /> " enc <br /> CONTRACTOR ADDRESS: <br /> CONTRACTOR PHONE: 0 S7ATE 4° B : <br /> 0 CONTRACTOR wi ' r, .r ..,. _. Pottis__rt a .c <br /> b 40:00,,,,E ),; taZA Agin " <br /> PRIMARY CONTACT: Q OWNER tYGONTRA,.,C <br /> TOR d OTHER(Please Specify) <br /> CONTACT NAME: <br /> 'De a„o CONTACT PHONE: Z C�D <br /> L Y.)uz. coNTA T EMAIL: <br /> g <br /> Ant <br /> Contract Price of Work:$ r <br /> 2`7")00$41 <br /> Use 3f 3r€It. in <br /> 3 €i[{n T aiea '613,..r•- .eeas 0Fla:t"it her <br /> ❑Ot <br /> R-O .a ha r nE OD i <br /> > '.ate <br /> :ap L�'I.�LtuiF atl 46.00f Unit-i-: _ _ mai�ia! <br /> T`ifa of P'r)fe . 0New DA:fdi_,Jr4 0Rema:fsi �;aaair OT 1. 03i f/ 'a rinicte D: n. �f i <br /> Si C�: <br /> 0E :.Rte rIO,i OF r1VORK: 14 ©11�riT3(iaa t I�_A _of Uss <br /> Iv1 .,,,fvy0 <br /> <; L,f.. <br /> A333ifY.TED E3`,1tL.'3[Naa PERMIT f`Cif aooc'^3bte'. <br /> is , <br /> Type of Project: _New �.. Addn _Alteration � �* { ;,� � � �� <br /> of r Rapefr Type of Project: Naw <br /> kima "._, a *ga ,�.Addn �Alteradon <br /> �Repa(r <br /> F ' ---1,4114‘'r,-- #of #of <br /> AIC"—Air Hanan! tJ�ti r fifes - �r�:� �t�fu�+;�f�rrrt�.-...._.._..:,.Y.._.:: . <br /> Forcedallinlam Air a stem Heat PUS IMIIIMIMIIIIIIINIIIIIIIIMIIIMIIIIIII <br /> Gas Piping atht f' urinalaw"Pravr l er Inside Bid . <br /> o. er urinal <br /> Water Heater NMI ave t Wash Kiri <br /> NEM ?Refi er t ch Floor <br /> r Fountain <br /> Gas.Fireplace shower FIooCtrain <br /> Wood stove Mei Kitchen Sink&Dis.csal <br /> MIN Grease Traii <br /> er Hookups Other: Ro f'arGGrfis <br /> ..11.111 Clothes C Rase Hisclothes Washer Medical Gas <br /> tt€a <br /> 5%n4 aNlt~emar!mc te#c, <br /> 4YEM o¢ . ENE <br /> Chemical cr Water <br /> fici cf Needs <br /> ACKNOWLEDGEMENT:_t have reviewed this appficancn and ccrfurr,the Infcrmaticn ccrlaired herein is True and ccrrecL Erikrk Dees <br /> current federal,state,and iccat law_ The granting Cl a permit cnty suihcites apgreved wain end cc deviaticrs Me:efrrm res+fagsns oval first to eutl„crizeri In willing <br /> frern the <br /> J=uitdirg C�cia/haters teirg autt;criaed under any �aarsrt is#tis perm*must cerr,Fhj wilt•. <br /> 7 FOW oral ce.1 am theWA C.cwrer,erten:aulh.Ctized ty the cwrer cfThis F2Feriy tc perfcm the v crk to which,aFF( alfcr.is merle, <br /> E d i ccrngtyCffi with the Sidle 5U(hcdZC Law r a FCJd and ne.i a G the <br /> City c9 Ew6reli Cfcist Use CO? <br /> LC '� } g ( PERMIT 4 <br /> CwiertAtrltr ref A Signature 0 9 t Cj y�/V/lJ ' <br />