Laserfiche WebLink
r- x 2tSI4 <br /> r _. 3200 CEDAR STREET,EVERETT,WA 981u7 evereftwa.gov/permits <br /> (P)425-257-8 FAX 425-257-8857 J(E)evereffeps@everetfw I <br /> aa& :®u.( 4iF. '..116 . ai pQ0 -6) : .., t.,G 64. OTtq.t 11 [1801 til rgfg ..: .. <br /> 12120/4-6120/4-6`3 41.4-1-' PROPERTY TAX 4: <br /> PROJECT SITE ADDRESS: /-7`r/� � 6� / <br /> Lot No. (attach copy of long legal description) <br /> LEGAL for neer construction: Short PlatfsubdivisIon ,- . <br /> - `: f - -- TENANT NAME(If Commercial}: <br /> OWNER NAME: ! �� • <br /> 25c�� - 7.%i A 6 ', <br /> OWNER MAILING ADDRESS: STREET - Wet ZIP GJc'�2SD 7�(p <br /> art ,t4./.,1/ 0 s • <br /> STATE U�11t L <br /> 77 ' q‘ (6 OWNER EMAIL: .... ., <br /> OWNER PHONE. ,.....�. . ,:. .rt........... .......x.1.._,.:. _.. . . .,. ,. <br /> CONTRACTOR NAME: L c?L—1 Cat ,,...,,,:.3 .- r , <br /> g /L <br /> STREET '2t,Z0 14-1.4,:141(„C-.. <br /> CONTRACTORADDRESS: STATE LOA, Zip Ci V C <br /> �5 Z- ,5((4- CONTRACTOR EMAIL: t=Lave-=Lava).-g...%WI f.,JG�=Co Ai <br /> CONTRACTOR PHONE: H25 - CITY OF'252-- <br /> BUSINESS LICENSE#(REQUIRED): � ••I� <br /> LICENSE-(REQUIRED): t�� ,, . <br /> - - <br /> CONTRACTOR - - - - <br /> PRIMARY CONTACT: ❑OWNER %CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT PHONE: /its- •j0 07-7-? <br /> CONTACT NAME: . <br /> CONTACT EMAIL: wry G1 O�5i-y7t.F=.�.6,),n <br /> - — — - . . - .BWWODING. >I --- <br /> P j IVtI`ii;A6? --- — ® �C <br /> Contract Price of Work:$ Ys <br /> Existing Use Use Building: Heat Source: Vines 0 Electric _ DOther <br /> Proposed or'Building: .mmercial �tndustrial <br /> Building Type: ❑SFR Detached ❑SFR Attached ❑Duplex ❑Multi-Family4 of Units: • <br /> Type of Project: ❑New DAddition ID Remodel ❑Repair QT.1. ❑Sign ❑Sprinkler IIDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: .1,.i,/-/{-s--Y� (QP,(�7— doef5 /Lk - <br /> ASSOCIATED BUILDING PERMIT#(if applicable): � I � d a .�� iON <br /> Type of Project: New Addn Alteration Repair <br /> type of Project New . Addn _Alteration _.Repair hof dor - List of Fixtures <br /> of °f List of Fixtures , List of Fixtures Fixtures <br /> List of.Fixtures : Fixtures Fixtures <br /> Fixtures Toilet Backflow Preventer(inside Bldg <br /> A/C-Air Handling Units i Heat Pump Urinal <br /> Forced Air Systems , Unit Heater Bathtub 'Drinking Fountain <br /> Boiler Lavatory(Wasn Basin) = Drain <br /> Gas Piping Shower Floor <br /> __ Reiteration <br /> • <br /> j Wood Stove Kitchen Sink&Disposal Roof Grease Traprs <br /> Gas RangeFeDucting Dishwasher <br /> Gas Clothes Washer Medical Gas <br /> Clothes Dryer Hookups Other: • mimmtnezzaina <br /> RangeHood Other: <br /> Exhaust Fan SinkOther: <br /> 1111111 <br /> I <br /> I <br /> Number of Heads -- <br /> authorizes approved work and no deviations therefrom.Deviations must first the authorized <br /> ut ho ized in applica <br /> tion oon is made, <br /> ,CKNOWLEDGEMENT I have reviewed this application andconfirm the information contained herein is true and correct.Work done pursuanto this permit must comply with <br /> m the <br /> r <br /> urrent federal,state,and <br /> local law.The granting of ca permit only properly p <br /> wilding Official before being authorized under-� circumstance;I am the owner,ori am authorized by the owner of thisto a onn <br /> nd I comply with State Contractors •f 18.2 RCW and 296.200A WAC. City of Everett Official Use Only . <br /> PERMIT n \1�A <br /> �` - t,', / I(Revised 5!20/2096) <br /> Date <br /> ..___.,, .oa,,,•iyoAiAnent Si4naiure <br />