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� PE�RMIT APPLICATIOnA � <br />BUILDING / MECHANICA� I PLUMBING / SIGN `SPRINKL.ER / DEMOLITION <br />G1TY OF CVERE7i P�RMIT SERVICFS <br />3200 C�DAR STREET, CVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 42a-257-8857 �(F) everetteps�evel'et.twa.gov � wwuv-ovcrettwa,gOvlpermlts <br />PROJ�CT 5�1�� ���ORNIATIC��1, <br />pROJECT SITE ADDRESS' �j� � ��1' , �-�' �� P�rv� LTAX #: ,�y �� � � ��� ��� J�.� i �� <br />y� qj �;i <br />�EGAL for new Constructlon; Short Plat�subdivlgion �ot No, (attath Copy of long IaQ�I description) <br />CONTA,CT IN�OR�IIIATION. <br />OWN�R NAME: �(� �� �' � v }Y� T�� � � � fENANT NAM� (lf Commel'Cidl): <br />OWNER MAI�ING A�DRESS: <br />°.R PMONE: � �.� - <br />RACTOR NABA�; C� <br />srr�eer .�� 1 � fi�-- <br />��n �V���� <br />8�—�I1 I <br />C�NTRACTOR ADDRESS: sTRF�T <br />cirr <br />CONTRACTOR PFi�NE: ��� c.�" L� 4 <br />CONTRACTOR LICENSE #�(R�QuiRED): <br />PRIMARY CONTACT: 0 OWN�R � <br />CONTACT IVAME: <br />C�Y'GJL G� �, � ��C'ii� <br />Ildln <br />Use of BUildinc <br />d Use af Buildi <br />STAT: <br />OWNER EMAIL: <br />'l ri� <br />>�- T ��, 5E. - <br />srnrE <br />21P <br />71P <br />�j ' O J � I CONTRACTOR EMAIL: �jO��(' �' <br />� [�� ��,�'�„'.�. (�i� CITY OF EVER�TT BUSINES8 IIC�NSE #�IZEQUI <br />ONTRACTOR Cl OTI-IER (Please Speclfy) <br />GONTACT PHONE: a , g � ---- ���,I <br />CONi'ACT EMAIL: C,�r�� G/„� C r��r vtir �Gr-�-r�r.� <br />— �� <br />BUII.DING M��RrMITAP�I.�CAT10N,� <br />� ��/ 1 14 Contract Price of Work; <br />J�L�1�iifJ <br />� Haat SoufCe: ❑Gas <br />:hed ❑Duplex �Multi-Familv� of Units: <br />eCt: CaNew I�Additlon ❑Romodel �epair ❑7,1, <br />ON OF WORK: <br />R�mov� CotM�. '�'�0�� � <br />ASSOCIATED 6UILDING PERMIT # (If appliCablo}: <br />M�CHdNICsA,�, IPERM�1' APp�,ICATIO�I <br />Type of ProjeCt: _N�w Adtlr1 Alte��tivn _Repair <br />Fi tu es ��St Of Flxtuaes FPztU es �4t of Flz(ures <br />la/C - Air Nandlln Units HeAt Pump <br />Forcad Air 5vstems Unit hleater <br />Gas FiF <br />Watar h <br />Gas Fir� <br />Gas Ra <br />Glothes <br />ler <br />LIEIeGkrlc DOther��, <br />OCommerclal �Industrlal <br />�Demolition QChangE of EJse <br />r�,�o� �x�e� �/ C.c�mp. ►'�c�o�. <br />SPRI�I�CL,�R / �UP�R�SSIO�1 SYSTEM � <br />Number af Heads <br />ACKNOWLEDGEMENT: I havG �'Cvir;wed this appllceflon antl Confirm ti�e lnlormat/on co�t&rnCC Me�'ei�� fs Irue And corrett. Wofk done pUr5uRn1 to rh/s permil must comply wltf� <br />cuiront fCdCraJ, St�te, and locel lew. THo ql'enfing of a permit only autHorizes epprqved work end no dAviations tllerellom. Devletlons must filsf bC wt�orized In writing nom the <br />�ur'ldfnp Officlai Ae%re being euVnorizcd under sny� clrcumstaneo. I am fne owner, ar 1 em autHorrzed by tno owner vl rhls prapeRy fo perform 1he wak lor whieH appllcetbn is made, <br />nnd / con7ply w/rh !he Stete Contracfors Lew 18.27 RCW end 296.200A WAC, <br />City 0l Gvcrelt Olflclal Use Only <br />i�ERf�IIT . <br />�3 � (�0 5- 03 <br />(Revised 90/1220 <br />