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09/15/2p16 THU 9:�7 FAx 425 252 1666 CM Hedting <br />• <br />i <br />�003/ODa <br />PERMIT ApPLICATION <br />BUILDING / MECHANICAL / PLUMBING I SIGN I SPRINKLER / DEMO�.ITION <br />CITY OF EVER�TT PERMiT SERvicES <br />3260 CEDAR STRE�T, EVERGTT, WA 98201 <br />(P) 425-257'-(i810 � FAX 425-257-8657 �(E) everettepsGmavarettwa.go� J www.evereltwa.govJpermiia <br />M'ue�,.�ar.M�la�lc'�1�i4�� 4�i1y���,��asel, : . , pkQJE�T $,�'TL�:jN bRM4T�oM.'�- . � � , ' _ <br />?ROJECT 917� ADDRESS: 1O� C�'` q`�'�1 �� �'�, IPROP�RTY TAX#: <br />-, <br />LEGAL for n�w aonstructlon� Short PlaUsubdlvlslon Lot No. (aitdCM Copy ot lon� Iagal deacrlpUon) <br />� ' • '� � ' �l�NT�. •�Y IN�'l�Rl�ll�1'I�Ik1�il� � � , <br />OWNER NAME: �11 ��l TeNANT NAM� If Commarciel): <br />OWNER MAILINO ADpRE3S� 9TREET I lJ`�!� �'T�'", � ��_ <br />ER PHONE; <br />CONTRACTOR NAME; <br />CONTRACTOR ADDRE$S; <br />cirr <br />9TRE8T I. "1 <br />cirr <br />CONTRACTOR PFtONE; � O�^�j � t <br />CONTI7ACTOR �ICENSE #(REQUlR�D):� <br />PRIMARY aONTACT: � OWNER <br />CONTACT NAME: ������ <br />` <br />EMAIL: <br />STATE <br />3TATE <br />coNrR�GTo� �Mai�: r � � <br />.�� rI CITY OF EVERETT 9UBINESB LfCEN9E <br />NTRACTOR � OTHER (Pleess Specify) <br />CONTACT PWONE: � � � � � <br />CONTACT �MAIL.: i�I�O� n(aI�-�1 i�G�fli�l�.Gki <br />,�,- �•., , ,, .. ��'�BUI <br />Exlstfn Use of Bulldln : <br />Pro oaed Use of BuIIdIn : <br />Bullding Ty e: OSFR-Detaclied C]8�R-Attachad <br />T e of Proect; C]New ❑Addltlon ❑Remodel C� <br />DE3CRIPTION O� W012K: <br />Contract Prlce oi Work: <br />Heat Source; ❑Gas <br />lultl-FamUv-# of Units: <br />❑T.I. ❑Sl�n ❑Sprinkler <br />���15�, �,,�" �'�p �e�r'n <br />�� <br />A390CIAT�D BUILDING PERMIT # (If annllcehlel: <br />ZIP <br />21P <br />u� <br />�'Yl <br />$ � j �-( , 00 <br />'��leCtrlC 004her <br />C�Commerolol Olndustrlal <br />L�Demolltlon �Change of Use <br />ACKNOWLEDOEMENT. ! haVe revlewad thi9 appllcAtfon end canRrm the InfOrmdtlon contelned hereln Is trua and corracf, Work done purauant to th/s permlt musf comply wlth <br />currenf /etlaral, .gfafe, and /ocel law. The granting o/ a permll o��ly eu0iorizes spFmved work end nu devlallons tnAra/rom, Devla!lons musr flrs! he autRalzed 1» wr;ting /rom ►he <br />Bullding O�f(c!a! befo.� be/ng autharizsd under any clrnumstencs. I em tha ownar, or I am auff�o�Ysed by the owner v(thls proparly to perform fha work for whleh aAAyoat7on Is made, <br />�nd I compfy wlfh the State Contr�cfors Lew 18.27 RCW and 299.200A WAC. <br />Aeent <br />C!(y of E'vereff OMclel U9e Only <br />� I �� � �� PERMIT # � � <br />Date (Revlsed 20/201 ) <br />