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OS/12/2016 FRI 9:�8 FAx a25 252 1666 CM xeating �002/�03
<br />� PERMIT APPLlCATION�
<br />BUILDINC3 ! MECHANICAL / PLUMBING / SIGN / SPRINK[��R / DEMOLITION
<br />CITY OF EVERETT PERMIT SERVICE5
<br />3200 CEDAR STREEi, EV�R�TT, wa 9820�
<br />(P) 425-25T-661p � FAX 426-267-086T �(F) everatteps@everettwa.qov � wunu,ever�ttwa.gov�perml[s
<br />PRO.lECT 61TE ADDRESS;
<br />LEC3ALFornewconstructlon; 3h41tPlat/subdlvlslon
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<br />OWNER NAME: (�
<br />OWNER MAILING ADDR688; BTREET I �
<br />Grr C.i�`i
<br />WPIER PHON�; ►
<br />�NTRACTORNAM�:
<br />ONTRACTOR ADDRE88: arReer
<br />criY
<br />CONTRACTOR PFiONE: �
<br />CONTRACTOR LICENSE #(REQUIR�p
<br />PR�n�ARY CONTACT, 0 owN�R
<br />C4NTACT NAMEs
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<br />� PROPER�Y TAK *:
<br />IJo. (altech copy oF IonO legal deecrlptlon)
<br />T6NANT NAME (If Commerclal):
<br />OWNER �MAIL;
<br />srar�
<br />9TAS@
<br />ZIP
<br />I IP
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<br />CONTf�qCT4R EMAIL� �,ji�/�.jl 1( :�,Q�j'(j�
<br />� I(�n CITY OF EVlflt�TT bUSINL98 �ICEN9E �(REQUIR�D):
<br />0 OTHER (Pleaee Speclfy)
<br />CONTACT PHONE; '
<br />CONTACT �MAIL; � r �Q�
<br />�i ��;��i�. ,�M1:��yi�:��j6� ,�'�,��,�• �"��� '?!dl� ,r:iiA'"� ^ra x� � ^7--r.-,mv.�--•�---?-,�,.-.-r-.v.�-r�rr...—.r^'_�.
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<br />Exlstfn Uee of Bulfdln : �ontract Prl�e of Work; $
<br />Pro osed Uso of Bul►dln : Hept Source: as ❑�lecfr(c ❑Other
<br />Bulldln 7 e: ❑5FR-Detached ❑SFR.Attachad ❑Du Isx ❑MUItI-Facnll -# of Units: ❑Commarclal ❑lnduslrial
<br />T e of Pro ect: ❑New ❑Addltlon l�R�mqdel (aRe �Ir ❑T.I, ❑Slgn C1S rinkler CJpemolttion QChan B of Use
<br />DESCRIPTION OF WORK:
<br />,��.5� �.s ��� � � �k u�.p � � �`�-� � o�s ��p � �
<br />A$80CIAT6p B ILpING PERMIT #(If aoDllcahlal�
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<br />,..; ,.« ,,. , ;, ., . ; , . _.. ; . ,;,,, , -
<br />Type of ProJact; _New _ Addn �Ai�B�etlon �Ropalr Typ. of ProJaat: New Addn Alteratlon Rapair
<br /># of �/�t o� F1Xlur'es � � a�
<br />�lxEurea FlxfUras ��af o��frturea ��X��ns Lla1 o/F1xWrva R�luYee tlst oI Flxtu�as
<br />'A/C—AlrNandllnaUnita ua9ro��Mr T..,�.,F .,__�.n_._.'..._ ._ . .. .
<br />83 R9
<br />IOEhes
<br />Exhaue
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<br />�sher
<br />s Wes er
<br />Heater
<br />9
<br />cal Gas ,
<br />A�Kn�wcEooEn4eNr,• I heve rev�ewed tnls pppl/Catlon snd conllrm fha fn/a,ng�lon aonre/nad harofn la �ruo end oomeo�. Work done pursuant te fhla permlf naust comply wlth
<br />currenf �ederal, stet�, end local lew. The arsnt/np o/a permR only aUthwlzes approv�d work end no davlatfons tnarAlrom. Devlstions muaf �J�Bt be euthorized fn wrlflnq /ram ►he
<br />8u!lding OfJlc/el bafore be!»q �utharlaed undRr qny clrct�m�fanCe, f em Iho owner, or 1 e/n authurlsed by the owner of Ih/a property In perform tho work lor whlch eppJlcaNan Is mede,
<br />and I complyWlth fha Sfafe Confrectara Law Te.p7RCWend 2BB.200A WaQ,
<br />C/fy of EvarAM OA7c/a/ Use orrly
<br />PER I . �
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<br />�Revrssd a✓2a2oie�
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