Laserfiche WebLink
PERMIT APPLIGA3IAN <br /> BUILDING/ MECHANICAL/PLUM8ING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERM{T SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> {P)425-257-8810 j FAX 425-257-8857 �(E)evareti���r�re�$w�,ge�� www,everettwa.govlperrnits <br /> �lue or�i��k Ink��t��I+e�k�, ��C�i��?'$�''�"���� ,� "�"��� <br /> _ <br /> , _ : <br /> PROJEGT SITE ADDRESS; �� PL ` PROPERTY TAX#: <br /> LEGAL(or new cons[ruction: ShoR P���tsl�t��tui�}ari� Lti�No. {attach copy of lang legel descAptlon) <br /> �S`��'���'���'""����'��� <br /> OWNER NAME� TENANT NAME�{�C+3i�tri�+�r�i�[�a <br /> OWNER MAILiNG ADDt2 : srReEr. �� �) �I..� ' ' <br /> _ �/`� <br /> . G7Y. .��_ � . .�! , ... STATE �..�� . .. ZIP... �G.(.J <br /> OWNEB PHONE O <br /> �� � � �O� OWNER BMAILi' <br /> 'CONFRACTOR NAME; f; £ <br /> > t�:��� <br /> '�ONTRACTOR ADDRESS srREet ,�I _ <br /> '_ <br /> �� .� . . � STATE ,�?�`�__ ZiP ����.. . <br /> �C?�I"TRACTOR PHONEff � ��NT6�,A�T�R EMAIL: d��l�'.: ? ..������ ..' ;:'�. <br /> CONTRACTOR UCENSE��tEf��;it�ECa�,�h-CC�,l�"Li����Zd n �t�'y OP EVERETT BUSlNESS LfCENSE 'REE�t1lt4��},, �" <br /> �_ . . , _ . _ �._ - ..� � _.. -_ ...,..: . _ _.. <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> ___ _ <br /> CCyNTACT NAME: � CON7ACT PHONE <br /> � ��'_ . ,. ,. <br /> ��i���+� CONTACT EMAIL: � �`�� -: � y^'�- �� _ <br /> - C�+� t�. Grh�'L.��i •�M <br /> „ , _ <br /> ����,. � ; � ,� ..t <br /> ,. <br /> ���� Usa of B.�ii�i : . Contract Price of Work:�i � <br /> I� �i Use of�i��#s#Iri , Heat 5ource: ;�5 ❑Electric ❑Other <br /> _._ _.......... _ <br /> Buildin '"f �:.; �R-Detaahed ❑SFR-AEtached �;fltdplex ❑Multi-Fami •#of Units� ❑Commercfai ❑Industriai <br /> T �of P�js��;. ONew �Addition ❑Remodel t7t���ir ❑T.L ��' n, ❑� ��k1�r ❑Demolition O��i�r� ,.of Use <br /> AESCRt�?T`1t'b�f O�W{3RK: ��Q�+ � "�N'�V�.Q..C,Q,r � �T'.Z� _ <br /> � <br /> A5�f7�1A'TED BtlILDING PERMIT# if a' G�f51e:' <br /> ME�1#AtaJM1�A��',�R�VI.t"��k� _, ��'t`�4�� P'L���{B��it�f� � �"1'A�!�'t�lCJ�"�"IQ� <br /> Type of ProJecL• �New _ Addn Alterefton Repatr Type oi Projecf: New Addn `Alteratlon _Repair <br /> #of Llst of Flxtures #of ` _ � ._ ___ <br /> Fixtures F/xtures Llsf of Flxtures #of Llst of FlxturAs #°f Llst of Flxtures <br /> Ff�ures _ Ffxtures <br /> ��. <br /> ` A/C—Air Handlin Units Heat Pump Toilet : " Backflow Preventer Inside Bid <br /> Forced Air Systems "° U�ft Heafer Bafhtub 'Urinal <br /> _ <br /> Gas Pipin Boiler .Lavata 1Nash Basin) Drinking Fountain <br /> Water Heafer Refrf eration' Shower Floar Drain <br /> Gas Fir:ept�ce, ', Wood Stove �Echen Sink&Disposa[ Grease�"rap" <br /> Gas Ran e : Ducfin Dlshwasher Roof Drains <br /> Clothes Dryer_Hooku s Other: "' Clothes Washer Medical Gas <br /> Range Hood Wafer Heater Otfier. <br /> _ _. . <br /> 'ExhBust Fan Sink Serv(ceBarlMopletc.: ' Other. ' <br /> �F'��t�i,�s��S��'������#�i",1���(1�I :- <br /> _. _.. <br /> Chemical or Water No,of Heads ' <br /> ACK/YQWLEDGFMENT.�I have reviewed thls applicafion and conifrm the/nformafion contalned hereln!s tnta and correct.t{Fcar^Xt done pursuanf to thrs permit musl comply wlfh <br /> current fsderal,state,and local faw.The granling of a permi!only autho�izes approved work and no devlallons fherefrom,peNaNans musi flrst be author/zed(n wnling from the <br /> Bu!lding Offfcla!beiore being authorized unde�any circumstance.!am fhe owner,or!am aufhorized by lhe owner oi thls property to per/orm the work for whlch eppl/calJon is made, <br /> and I comply with the Slate Contractors Law i8.27 RCW and 296.200A WAC. <br /> Clty of�verett O�cra!Use�:t�r. , <br /> _ ; F�Q�� <br /> � . n �• � pE � 1 �# �- �V1'. <br /> : `7'� � <br /> . _. <br /> "t�wise l�utharized,Agen Ignefu�e. . Dale `(�avisa�E!'�' 476� <br />