Laserfiche WebLink
G°PL�G�d�l �[��'L��t�Q`1����N1, <br />C�M�L�O . 9��Ih1G�P�0��Lf� / [��,�G�i C�81i�� � ��� " � °���I' `�L�,[�(� 6 �� uV�Il�L1�0�"('��� <br />� CITY OF EVERETT PERMiT SER� <br />3200 CEDAR STRE�T, EVERETT, VNA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(�) everetteps@everettwa.gov 0 vuww.everetiuva.gov/permits <br />��g����' �6�'� �N���b�l�5i��� <br />',6��:OJECi �BTE �D�3�E�S: �(01 � ���t.��.s-�' �'✓� �������'l° 1'�1C #: �� � D �%G�C��Q I C� � ( <br />L�G�L for riew construction: Short Pla�/subdivision Lot No. (aitach copy of long iegal description) <br />���g��� 9��'����i���f� <br />O1fV �9�� �9A6Va�: �G'�rQ � 1�VLG�' � �-- �'''�.� g� �'��A�IT R9�Rl�� (&fi �o�ae�Qrc's�6�: <br />OWR�E&i f1�P+9L9�1G ��DR�SS: srReer �'°?� � � �!l,s�lilLt�'�--� �1! � 1� <br />cirv �l/P�-��� srn-rE W�r z�a � ��O � <br />ow��� ��c���: �l- �.5 • 252 - �e7 c� � �s���� ����.: �.rA-v-l�. '� ��..-�-� e��� � e��o • �� <br />co�arra�c�o� ��s��: '%MCZU-� � J i= �� S E� � o ti�S `� ;! E,..�"d ._� <br />COiVTRlAGT0�2 �Di�R�SS: <br />��� �����: � �. <br />T06a LICE96SE #(REQUf <br />C0�9%'&CT: C�OWNER <br />Pd.491�E: <br />s�ueer ,:��j <br />,a <br />cilv Z�, �� a��-- � i> � srare LC � <br />�" -- � 3 �� o s3/O ������� ���sL: <br />RED)• �/�,.� ;t� .�C� d 7,Z/{/Q � COTY OF �V�R�if �4J�GRiESS L9G�ROS� <br />C�CONTR,4CTOR � OTHER (Please 5pec'dy) <br />CONT.4C7' PMOIdE: <br />C�f�TACT �INe4f�: <br />ZIP <br />r'7 <br />�9lILD91VG PERDVII'9° �1PPLlCA'�'�OId <br />Existing Use of Building: �jl' y����� ��tract Pric� of 4�loric: $ � <br />Proposed Use of Buiiding: °° '� U �� Heat Source: �Gas 6�`lectric ❑Other <br />Building Type: F,�SFR-Detached �SFR-Attached ❑Duplex �Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Projecf: ❑New ❑Addition C�Remodei IS�epair �T.1. �Sign ❑Sprinkler C�Demolition ❑Change of Use <br />DESCRIPTIOEd OF 4�POR8�: � �� C���� � ����,� � �� <br />"t <br />A�SSUC1,4i'ED �UBl.DI�9G G'EFtkN91T # {if applicabfe): <br />�����a�� ����ao� ����o��ra�u� <br />Fype af Peoyeefi: llVew Addn _,4lterat6on ✓ R�pair <br />��¢ Lisi of Fi;rfures � of List of Fint�eres <br />�IXI't6P�5 d�IXglBP�S <br />Tailet BackFlow Preventer (Inside Bldg) <br />Bafhtub Urinal <br />Lavatory (Wash Basin) Drinking Fountain <br />. ShovNer Floor Drain <br />tCitchen Sink � Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clofhes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/eYc.) Other: <br />ACKNOWLEDGEMENT.• l have reviewed this application and conFrm the informaSon contained herein is true and correcf: Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granfing of a permit only autho�izes approved work and no deviations therefrom. Deviafions must frst be authorized in writing from the <br />�uilding O�cial before being au�horized under any circumstance. l am the owner, or I am authorized by the owner of this prope�ty to perform the work for which application Is made, <br />and ! comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett O�cial Use Only <br />/_ / _ � � PERMIT # -� � � �� � V � � <br />�/iiv� <br />Ovus�erlAuYho ' e¢d Ageeut 5u�ma2aar� Date (Revised 90/92/2015) � <br />� � <br />