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PRIT <br /> BUILDING /MECHANICAL EPMt1MBINGGATtON <br /> I SIGN I SPRINKLER I DEMOLITION <br /> "1111°.1i1WW1V--/"."A <br /> v_ CCTV OF EVERETT PERMIT SERVICES <br /> 3230 CEDAR STREET,EVER,WA 33231 <br /> ?)4.25-25T-331) I FAX 12.5-25r-335T i k )>.rer3ttaose•?.v.wa"wa,gov I wwwevarattw3.guy/pe-mf3 <br /> (Slue or'Black trik Qhi, t'leaaa <br /> PRO:tDT1fiW1NFttl�ill 'i'"l_f.�N� g r {. <br /> ?tRb1ECT SITE ADDRESS: ©�..�+b ,_- . ' <br /> ( 1-4o I I fir, _ <br /> LEGAL f3-new cons;rucon iPRQPERTY TAX if: <br /> Sia PROPERTY <br /> to.:No.' (attach copy of long legal description) <br /> r CONTACT:NfO MATlON - ` <br /> L ...a V`Qv1 — <br /> r t U 1/ ENA`aT NAME if Corn mer^isf <br /> O: .i_:R :llA'L 1\3 ADDRESS: ;T _z-- 4o( E <br /> ,i l._2 .O1 ATA r-_ thr'13 L &C20 V& <br /> 04�#,'*#ER piONE: '4it5 �j i 0�oo <br /> " .. I04i1NERc4rtAfL: <br /> CONTRACTOR NAME. t4 .a1 ' i tri C <br /> CONTRACTOR ADDRESS. ir <br /> sr4_E.T l 4 i oa.ctw is <br /> circ ` , Utz <br /> CONTRACTOR PHONE: STATE A. ziP ` : 20 1 <br /> 25 R 0 SO CONTRACTOR EMAIL• k s <br /> PRIMARY CONTACT: OWNER _. as. t-ter l`Btl ttd a I a • W r..❑ CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT P <br /> HONE:. _ .- <br /> Z5 25' 0 it� j <br /> Co Gao . .� <br /> =y 1NG?EtM Ti T . . .:: <br /> -xt�t� Use:of B�rtdr; Contract Price of Wor• <br /> _Mi <br /> 3�ri '. r y� : Lts-RO Fax F e _-_ <br /> �J�R AF.acnad <br /> — !--� QD1ol�� L�.L{1fL arT. -- -- <br /> �Yc'�r?7j3xf: LJ:�{aVfr i]/sCddt;�z � ?r-r�?r Liras: ~=� ...3 1 _ _ <br /> 1 OPil�r <br /> cOR.�IStJf�? D li t T• 1 t '�{ �1�tR3� ; <br /> 3_>>.;-RIPTEONI OP WORK: <br /> -. ��:3R �, rl lKi3r e a <br /> • ita� 3 of fJ->e <br /> --lepla.ce ifocuai- -,0-)A-0-c-e_, - U Kg- • :Yr b 1 --',-- <br /> !ASSOCIATED 13:1[LDFNG PERP,FT <br /> Cf..oaiicaa(e), . <br /> . 7=11/1ECk'ANiOtAi-=pE`it-MtT <br /> ---. <br /> APPLiCATrOIi -:; x 7• <br /> y <br /> ,PL:UM� i3 "_ <br /> ot � ? L1tATIf �'"Type of Project: _ New Addn Alteration Reparr <br /> Ma <br /> mtamua. 1. <br /> r • i Liras - rca~-- #of iF of <br /> u=::::::= _ <br /> NC-Air Handling Units Fjfrjres' ` <br /> �'NC— Air Systems a Fixtures <br /> MU Gas Forced Bathtub Backflow Preventer Inside Bid.} <br /> 1.111111 Boiler 1111.1.1 Lavatory(Wash Basin <br /> Gas FireplaceMRE Refrigeration _Drinking Fountain <br /> Woodanizinzmommumm Stove Shower Greaserain <br /> Kitchen Sink&Disposal WWI <br /> Clothes Dryer Hookups animacromunint aim Ducting 1111111 Dishwasher Trap <br /> Ranee Hood Other: NM Clothes Washer Roof Drains <br /> MEM '' _ mum other: Gas <br /> Sink(Service/ear/Mop/etc.) � <br /> i <br /> r. <br /> 1Sphi NKLER`/=SUPPRE ,1o#,ik SYSTEM '_tl <br /> 111 v Nc.cf Heads <br /> LECGE1vt1=NT.'1 have reviewed this a <br /> IIIIIINIIIMIIIIIIMIII <br /> ..z c enr federal,slate,and Iccveal a Thea Fc+t alio.and ccr,}lih;the Infcrmaricr <br /> granting permit COly eutY.crizes a cwcrk arc) <br /> Ferre IS free and ccrcm Wcrk dere pursuant to this permit must ccn <br /> Cr.d rocg plCffy wilt <br /> before being enthcriers a 1 any F1 roved work and re deviations tF.erefrcm.Gavial/01a gust fuss to aulhtrf2ed in Wiling firm the <br /> drd 1 con: y circurr:stance.I a ani the CWrer,Cr I am aUnccrl2ed ty the cwr.Cr of this prey tC Ferfcrrl;the we*kr wt:ict a Fy wirY. <br /> FlywifF:the State Ccr,Jrcrcrs Law f8.<`7 PC',/,'and 25E.<CCA W..4 C. <br /> FF/rcaticr,is made, <br /> Citycl/`Leri•}}Ctficial use Crt. <br /> Cw,er/Aulhcrited Age. Igr-141 U A.0 - 1 t FE#sMIT �� t./2� E <br /> 9 Stg�aturn NI ` 1 <br /> Cale <br /> (Revised S/g:iiaC 1F) y <br />