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03/1Q/2p16 MOx 12:36 FAx 4252521666 CM Heating �pQl/002
<br />• PERM{T APPLICATIO�
<br />BUILDING / M�CHANICAL / PLUMBING / SIGN 1 SPRINKI.ER 1 DEMOLITIdN
<br />CITY OK EVEf��77 pERMIT SERVICEB
<br />320a CEDAR STREET, EVERETT, WA 98201
<br />(P) 425-257-8810 (�AX 425-257-as57 �(E) evereltep�(�everellwe,eov � www.evereltwa.govlpermlis
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<br />PROJECT 81TE ADDRESS:� � I� D G �! D ROPERTY TAX �:
<br />�`�Y.
<br />LEGAL for new oonstruotlon� Short PI�Vaubdlylelon Lot No. (�ltaeh oopy of leng I�gel descripuon)
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<br />���,;.., , � , ��ai�r4a�r r�F,�N,MATIQM
<br />OWNER NAM6: � TENANT NAME {If Comm�rclal):
<br />OWNER MAILING ADDRESS: eTReeT ,�� I(�� If�.�(�i� Q�P�J��
<br />PHONE;
<br />NTRACTOR NAME:
<br />NTRACTOR ADUR�38;
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<br />sraee�
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<br />CONTRACTOa PNON�; �-f p4� pr��-( Q�
<br />CONTRACTOR LICENSE #(R�QUIREp)�
<br />PRIMARY CONTACT: ❑ OWNER CONTRACTOR
<br />CONTACT NAME: �
<br />�-e�z-��-� �- Ctm%�-�
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<br />Exisfing Use oF Bullding� ,.
<br />Pro osed Use of B �lldln :
<br />13uildinp Type: �FR-Detached �=;4�f•
<br />STATfl
<br />OWNER eMAIL:
<br />1 6TATE -j
<br />� CONTRACTOR �MAIL; �
<br />� �{� CITY OF EVERETT BU31NE83 LICEN8E
<br />❑ OTFIER (please Speclfy)
<br />CONTACT PWONE: �� ��t o�i
<br />CONTACT EMAIL:fY�P1QPi�t�'ir'1JC�/('.VY1h �
<br />� ' �,�UILQIN�i-PLRMI
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<br />Type of ProJoct: C7New �,dditlon ❑Remodel CfRepeir
<br />C7�SGRIPTION OF WORK:
<br />� � � ���
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<br />ASSOCIATED BUI�DIN(3 PERMIT # (If applicabie):
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<br />'LIGATIOM � � �' , �
<br />Prlce of Work: S � Q
<br />❑Multl-Famfly-# of Units
<br />❑T.1. OSign �Sprink
<br />� � l 7 ,
<br />❑Eleclrlc �Other
<br />❑Commerclal ❑Indusirisi
<br />ClDemolltion ❑ChanAe of Use
<br />AC!(NOWLEDGEMENT.• I Hsve revlawed thra appllcafron and oon(!rm tha Inlormoflon contained herBrn la frue and correcf. Wvrk done pursuent to ll�ls permlf musl comply w/th
<br />currenf federel, atele, end locallew. Tho Qrentlny ol e permk only eulhorizea �pp�avad wwk and no devladvns th�refrom. Dsvlat/ons musl f/rst ba eu(horized in wriling lrvm tho
<br />9Ulldlnp Offlclsl before being eurhorized under �ny vircumsf�nce, I em the owner, or 1 ein eulhorized by fhe owner of IR/s proPerty to perform �he work for whlch appl/caf7on /s made,
<br />snd 1 oompry wlfh Iha 5reta Gvntrectors Lew 1 �, 27 RCIN and 2s8.2ooA WaC.
<br />Clty olEvareft O/llcle! Use only
<br />PER I7 #
<br />4�� � ��i� �����(�l
<br />(Revlsed 10/i2/20i6)
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