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BUIIDiNG i MECHANICAL�PLUMBING CS GNN SP
<br /> CfTY OF EVERETT PERMIT SER�/ICES RIN KLER/DEMOLITION
<br /> 3200 CEDAR STREET,EVERETT WA 9820f
<br /> (P)425 257-6810 � FAX 425-257 8857 �(E)�y '
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<br /> �.df No.' {attach capy of long legal descriptlon)
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<br /> �WNER NAME '' ��� �t V�" ` • R
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<br /> ��i�ER MAJLING ADDRESS;
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<br /> CONTRAC70R ❑OTHER(please Sp'scify� � m
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<br /> GONTACT NAME: _ .' . - _
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<br /> _ �ontract Prtce of Wort� $ ; ; ` :
<br /> �C# �ed:�Use of B�� �:, : _
<br /> B��j�i ��, ° : _ �.�Source ❑Electric ❑Other
<br /> �^�ch� �AtE��tsd ❑� t�� ❑Mulh F�ar�ra� < of
<br /> �" e of P� �' � �,lAddftion L�t��` C1C mmercial bl d
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<br /> C1Remodel � � � ' n ustrial
<br /> � ��F�t�1"tCt���OF WORK: , r �.. � CaTJ. D� r� _ ��pririkler ❑��Demolition ������of Use '�
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<br /> +�l'�w�C')'4:fATED BUILDlNG PEfiMiT# #��''' ;���: - ,
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<br /> T�S��of Projact �New� Addn Alteration ,_,_aepafr ���F� #r �;���a ��� ;
<br /> �` . TYpe ofi ProJeck �New ,
<br /> �� ,, , � - �:i+J' � � _Addn� �Alteretlon �
<br /> .: - #ol` —Repair
<br /> � #of
<br /> A/C ��'���i ���ti�� ,.P�� �`` Fl�tfuies ..
<br /> orced,�ae� ��: . ; �i��I��r� . ... �`ar�f m _ ��v��'�l'�`�r s1�t�
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<br /> � Wafer Heater , � �z��I+��' . �.
<br /> - �asts�asin �
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<br /> °ACKNOWLEDGEMENT.)have rewewed fhrs applJcallon and conflrm the lnforma0on conlalned hereln!s 6ve and correct.Work done pursuanl to th7s ermll must
<br /> current federal,stafe,and loca!taw The grent/ng of a permit oMy aulhorizes approved work and no devJallons theref�om.Devlatlons must 8rst be authorized!n writing/rom fhe
<br /> Aullding Q�c1a/trefore befng authorized under pny c/rcumstance.!am fhe owner,or!am eufhor/zed by 11�e owner of thrs p °Omply wifh
<br /> and I comply wRh the Stafe Contractors Law 18.27 RCW and 296.200q WqC,
<br /> properry to peAorm(he work/ar wh(ch app/�callon is made,
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