Laserfiche WebLink
08/17/2�16 wED 9:21 FAx G25 z52 1666 CM xeating f��02/V09 <br />� PERMIT APPLICATION� <br />BUILDIfVQ� / MECHANICAL / PLUMBING / SIGN / 3PRINKL�R ! D�MOLITION <br />GTY OF EVERETT PERMIT S�FtVICES <br />3200 C�DAR STREET, EVERET7, WA 80201 <br />(P) 425-2S7-6B10 � FAX 426-257-a857 �(E) everektepe(�everettwa.gov � tiwwv,everettwa.gov/permlts <br />11,16 �f'X f�. �k�fk� N1 QI�l�'�I�tl' �) `�', � P�O�I� F� �`[il� 'R 1► i ru , <br />PROJECf SITE ADDRE$$; <br />LEGAI, for new conalruoUon: 9horf Plat/subdlvlalo <br />�� <br />, ,. „� ,. i,� , <br />%� <br />OWNER NAME: �, C <br />OWNER MAII.ING ADDRES8 <br />WNER PHONE; � <br />ONTRACTOR NAME: � <br />—� <br />ONTRACTOR AIJDR�S$; <br />CON7RACTOIi PHONE: <br />CONTRACTOR LICEN8E #(REQUIF <br />PRIMARY CONTACT; ❑ QWNER <br />CONTACT NqME� <br />.� <br />$TREET � <br />ciTv �Q <br />sTRe�r <br />c irr <br />�, ,�,v.�.�,, ;,�,�, ,;,. ,,.. ,:,,�:,; ,.Si��r�• ' <br />Exlstln Use of Bulldln : <br />Pro osed Use of Bulfdln : <br />6uildin T e: ❑5FR-Deteched �14FR.�Alttelch0d <br />Type Of Pro�eCt; QN9W ❑Addltlon ORwmnrlAl 1`1 <br />�PaOPERTY TAX #; <br />No. (attach oo�y oF long legai dascrlpllon) <br />TENANT NAME (lf Commercla <br />ER �MAIL: <br />STATE <br />srare <br />Z IP <br />ZIP <br />CONTRAC�'OR EMAIL: ;�'}���' <br />� 1�� CITY OF EVERETT BU61N�88 �ICENSE t1(REQl11RE0j; <br />❑ OTHER (Pleaae �peclfy) <br />CONTACT �HON�; <br />CONTACT �MAIL: lMC e0or ,,, nn_�.�, <br />DE3C IPTION OF WORK: <br />� � � ���2r�� <br />A�30CIATED �U16blNG PERMIT # (If apppcable): <br />����r111ti:TM1l�w. • <br />Contrsct Prlce of Werk; <br />Haat gource: es <br />❑MuItI-Famllv-# of Units: <br />Typa of ProJ�Ct: Now Addn „�,qlteratlon Repulr <br />� 0/ L!s! orPlr�uYea � � # ol <br />F/xturea p��u�8 Llst o}i�lxtuna ��ful'6� <br />A/C – Alr Handlln Un fa �lest Pum <br />FOrC6 Air 5yatems l nit wafwr <br />r <br />Gas <br />t <br />n <br />� OO � <br />�Electrlc ❑Other <br />❑Commercial ❑Induetrl <br />❑Demolition �Change of Use <br />Typa Of ProJect: N�w Addn �IEaratlon Repelr <br />L/ato�Fficlul'ed F�r ures C�bt ofFfxlulsa <br />'011et Backflow Preventer (Inel� <br />C� <br />Other; <br />a�n <br />Tra <br />ICKNOWLEdGEMENT: I have ravlew@U thls �pplloaHo� en0 oonllrm lhe Inlormaflon conf�lned ho�ln !a frue ar+d correct. Work done pursuenl !o thls perml( must comply wlrh <br />�vrr�nr ledera�, afafe, and loval law. The prenllny� pf � porntll only authodsoa epproved work and no dev/a8ona tharolmm. Devle(lons musf tlret be a�urhorized rn wrlfing from Ihe <br />iu!ld/ng Ofi7v/el balore being authorhed under �ny a/raumatartce, / am tha awner, or 1 em eulho�lYed by the awne� 01 thls prope.ty ia parfarm ihe wak for whlch applicatlon is rr�ede, <br />�nd I comply whh 1he stafe Conlravrors l.ew id.27 RCW and 29B, 2ppq yyAC, <br />C/fy of Everett OfflCla! U On�y <br />PERMI7 # r_ �� ` , r <br />U lJ l � <br />ReVlaed 3/ 0/209e <br />