Laserfiche WebLink
�PEF�MIT APPLICATI� <br />BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everetl, WA 98201 425-257-8810 FAX 425-257-8857 vrr�v+.�ver� `a.lorg <br />C <br />ADDRESS: � ' <br />TA% p <br />-q� ao/�000v <br />_EGAL Icr new tAn,tr�cLon� S�ort PlaUsuOdwisron lol No._ (attaCh CADY of lorg Ieg�i CescnpLon) <br />JWNER E��KC/i l�driiv6 f1�l�o2n �no�.�e-ma, �Z .�Z.�� Z Z� <br />4Gdress�D �dii ��Y Ci,ylStalrJZip ��ii�/��%T N/%! �0 ��/ <br />APPLICANT:,�Gwnet _Qnn�fSAgenl _COnIraCOr _CcnVaC;or5F9en� �Tenant(musiwo.moeioemotm�,v�i�mww.+urwco.onm��eso�:el <br />rnuTaer.7[�R �N�� �i�Q Stale Lic. tt Ciry Bus. Lic. #UZ� plD� 1 <br />?honNEma!I <br />fENANT BUSINESS NAtdE GONTACT FOR PERmn��N� y h <br />V�lJ/ "� ✓/�- "� PhonelE�maJ G�� J 7 E <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � � <br />E�ishng Use of Buildirg J{F� HEAT SO <br />Proposed Use of Building 5F/� Gas E�ectr, <br />BuilQing rype: _ Singte Family _ Duplez _Townhouse ,_ Multi-Family _ Commercial <br />DESCRIPTION OF W ORK (add�honal space F�vide0 0o the back)'. <br />MECHANICAL PERMIT APPLICATION <br />Ty0QolPro)ec1: _Now_Addn� Allerailon_Repatr <br />Show Numbv (a) o! fixtures <br />e�r _ o1r honr111nn unita <br />heater <br />ISUP <br />TMF <br />' Tc' <br />iSl <br />PLUMBING PERMIT APPLICATION <br />o1ProJacl: _Now_Addn _AlloraUon_ReP�lr <br />Show Number (u) o/ fixfwes . <br />r <br />Mcdlcal Gas <br />Other <br />I �C�eOy CONfy I�dl I �a�o roatl ana eaam:na01N5 apP��eilion anE Mnow No samo lo En wo ane cortect. M pmvL•ions ol laws anG orC•.nance: pover'.:n9 Cils rype ol waek w�'I �a compl <br />wo.� w�el�er spnufieC �eroln or nol. TTe 0�^�ing of d partnii Ooes nol pre:uno lo ghe aut�o0ry to vlolale ar tanu� I�e piovl4on ol any emer;lalo orloeil Liw rcgulaLng conslroUlan <br />TTaI i am I�onxeC 0/y ine owner ol Nis propeny lo patlortn ��o woM1 lor wMN appFr�llon U maCo a�C I eompy wIN I�a $tala Comractors La.v t B 27 RC'.V ana 27�.�OOA WAC. <br />� / " • \J b �V I� <br />OwnerlAuthorized Aqent Slgnatum Date iRevised �2015) <br />