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MOORE <br />BUILDING PERMIT APPLICATION <br />EVERETT <br />SUBMITTAL INSTRUCTIONS: sae.MlicaebeNsubmittaPUecMkal3torsbmal requirements and number of comas regulreU for my," <br />wuxixare" <br />then drop elf completed a(NIiW4on plus all required! subrafti Eomments W 32M Cedar Sheet grid Flox Intake Drop Box. <br />CONTACT INFORMATION: (P(L2S25]-0B101(E)Pemr115erviws®evereitwa gov I(W) everellwa girdoermip <br />(Blw or BOpk Ink Only Phuhi PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET ` Z, <br />S PARCEL#: W /����.ss <br />anyW0.joit STATE WA <br />na <br />SUITOUNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): <br />TENANTIBUSINEn NAME (# rnnmerincentlal): <br />LEGAL DESCRIPTION Mrew cmatruct Shan RaYwWlvivon: Lot No.: pXaca mpy ofking "at desorption) <br />CONTACT INFORMATION <br />OWNER NAME: <br />OWNER MAILING ADDRESS: =or2 <br />any <br />OWNERPHONE: OWNEREMAIL: <br />1 <br />CONTRACTOR COMPANY NAME: L <br />WA STATE CONTRACTOR UCENBE k(REWIREDg <br />FEVERETT BUSINESS IICEXSE pREOUIRED): <br />CONTRACTORADORESS: <br />cm, TAM <br />nee <br />CONTRACTOR PHONE: CI - <br />CONTRACTOR EMAIL: <br />PMMARYCONTACT: IJOWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />CONTACTPHGNE: <br />CONTACT EMAIL: <br />BUILDING INFORMATION <br />VALUATION OF WORK: S AI ASSOCIATED LAND USE PROJECT N if applicable): <br />)V&uamn Wl Hyde Ne gwYYp Mlma NrWe amr`ma.d. qupramrcbM b ampM Ne wM1. wb✓r whWy qq and) <br />EXISTING USE OF BUILDING: <br />K <br />PROPOSED USE OF BUILDING: rx <br />HEAT SOURCE: OGas OBwdc ODmer <br />BUILDING TYPE: OSFR OTOWnhouse 00uplex OADU OMutlLFamily -k Unds'. Commercial <br />OAccessiM Structure <br />TYPEOFPROJECT(chackall Malapply): ONeWCanstrwtion OAddition FIRemodel CRepair EIT.I. <br />7Madular OPONable Vi$EfW1 OEMciw Nixation OTank(abolegrouM) ElAccessoriStrachure <br />OFarce over M high ORackStorage OPoolMot Tub OTank itaxve ground) 0ghec <br />OChatgeof Use <br />DESCRIPTION OF WORK: <br />(�ictnw��ilz I Rtot LurclrY0`Yk- <br />iu l <br />A CKNOWLECGEMENr I rid M ro remad Ma a memo! r year road" me macycliai wnulred M,eN,a More aM[enect. work done pursuant to INS perm nvss[cmp'y wars <br />Buml m ha .arataever real tam.The gral of remiwsatellitessatellitest satellites slammed xdk and to devarms Mandol. Delaware most FY de aWlwnmd reading man do <br />o�Niy Carmel de/wa bang aNhonzao once, any aavmatanml am lM delay P l am aWMniW by tM owtRr 0 Me porn to pe,from fee advk fa utiM eµ'iCar breads, <br />conmty rim led Sbte conVa[Im VT 6}WR WA C. <br />Crya,Ewmn Gameur Day <br />PERMIT# <br />ar pu o ud Aeant Syllable, Daro (ReNnd 4,214R)22) <br />