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PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING/SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810f FAX 425-257-8857 I(E)eyeretteps@everettwa4ggy! i+iww:averettmc Y emits <br /> Ii il$4iit'ttli iwon ;Pfeatit#3 :: t ,i-vit. J c, `€ <br /> PROJECT SITE ADDRESS: A 3C1Rai' i,„:0 <br /> it : l�� PROPERTY TAX# <br /> LECtAI,for new construction: Short <br /> t'Eetfsettidtvtsian Lot No.' (attach copy of long legal description) <br /> OWE NAME. a FCONTAC°f` *elaH `: "! tel; <br /> i .Ji A Ve y"CAS TENANT NAME Of Commerdlal): <br /> OWNER MAILING ADDRESS; STREET <br /> � ck Rainer &e: <br /> CnY... 61�i9 :. _.. <br /> - _ ,-, STATE,..Lt1 ZIP qQ 26 / <br /> OWNER PHONE: <br /> OWNER EMAIL: <br /> CONTRACTOR NAME, <br /> CONTRACTOR ADDRESS: STREET II+ brOaCtUt.9 <br /> • ' <br /> CITYJ J <br /> STATE �' <br /> CONTRACTOR PHONE: ZIP � � � <br /> CO <br /> " 15 Z R 0550. JCO TRA TCtR EMAIL <br /> G #SICK#s�Rt R Y �hcone' <br /> �.�. if`f Bt'StNSi"s tlr:Etit1 <br /> PRIMARY CONTACT: 0 OWNER <br /> CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: 425 2� L " <br /> CONTACT EMAIL a ,e j. .co <br /> ,, Use of uitdl a 180-0,...1.-1'.- .0# P +.�� r`� `�'P� ,..zr4ua�. s <br /> Contract Price of W .$ <br /> prt7aov d Use oflituildirir, <br /> Heat Source: A; as ❑Electric Qptt et <br /> _R9 ith .4 T i:: LSFR-Detached DSRAtts had ° ugx O�uIIi F' t)l4 of Units: <br /> ❑C <br /> 14,o of Pro 00t: ❑New °Addition °Remodel ClRepair 0.1.1. ° rg.I. it O prinkier °Demolition Q{ge of U e0strlal <br /> 04SCRiPTION OF WORK: <br /> Null nye u * : -FD <br /> L -{zf..n.K.USS WCel-er h2t�. -er- �- reloCale. <br /> teat t STI fl` " <br /> ASSOCIATED BUILDING PERMIT; "({J. li ie)' <br /> Typo of Project: __New Addn Alteration _Repair Type ofProJect. New Addn AlEeratlon Repalr_ <br /> a a t itewee.s—.. #of <br /> # f <br /> ASC--•�t$r l�t�+k = �ti> ttre.� � a1�=7�icrna;�-.•-••. -- �.�. <br /> Heat pump Toilet <br /> i=otdAfr �..r Backflow Preventers. <br /> Unit Heater inside S" <br /> Gas pi. <br /> roil Bolter <br /> Urinal <br /> L ry(Wash as ) Drinking <br /> g Fou <br /> ntainWatac Heater Refrt,eration, Shower Floor Drain Fire Wood Stove Kitchen Bink N .a 4. Grease Tlae <br /> as Ran.e I7ctOtirt <br /> Jslt�ter <br /> Roof steins O er ec rs Other: <br /> ltd Washer <br /> Ra ,,;- Hood Gas <br /> IwathaftstPan rt'. W9ter eater Other <br /> sink C at iioeaer/Mooiiin Otter <br /> (e"S IUUNK ER'Ir$* PP 5» $ YSTENt ._, ---- <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT./have reviewed this application and confirm the information contained herein Is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized In writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> I (• , PERM # <br /> cs, RO _ 1 k Li <br /> wrtature <br /> Date €" <br /> (hilt ed 90237201(7) <br />