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PERMIT APPLICATION <br /> BUILDING 1 MECHANICAL/PLUMBING f SIGN t SPRINKLER!DEMOLITION <br /> " CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 96201 <br /> p. x�t'p (P)425-257-8810 I FAX 425-257-8357 I(E estteos ,,e' rettte v I wv�Xevefiatev ,ROWParm%.s- <br /> attii Ef f'",©�atlrfC tt1�Ctj a ' <br /> PROJECT SITE ADDRESS: (: ,i,,,- _ <br /> LEGAL for new construction: Short r'(aJst;6dlvistsr: Al l.; a PROPERTY TAX ft: <br /> __. <br /> Lot No. (attach copy of long legal description) <br /> CON'T`;AC `l•;PORI A''1 e N% >t ,_ ,. <br /> OWNER NAME: i + s ,,"'` TENANT NAME fif CommerCjat), <br /> OWNER MAILING ADDRESS: , a.F <br /> m e " .aha srrtT° C.°1#1 it' <br /> z{� 1i <br /> OWNER PHONE: ' - t : . <br /> OWNER EMAIL:: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: ,T, -T <br /> 1t} <br /> • <br /> CIN go, It ,`t <br /> STATE LIP f �' <br /> CQNt RAGi R PHONE tt �`} <br /> CONTRACTOR'S WAR-41:-2,4p , 7• ...../AA! d ' CO <br /> 'ItMARY CONTACT: 0 OWNER " x <br /> CONTRACTOR ❑OTHER(Please Specify) �. <br /> CONTACT NAME: <br /> t CONTACT PHONE; <br /> » " CONTACT EMAIL , 4 <br /> Lyy <br /> Extern Use af$t�tl€fitrte a t "� —a <br /> contract Price of Work:$ u- 00 <br /> -Proposed Use of Bilil,LN <br /> itittdi . T=ae: f�Sf=Ft-ba Heat Source 1: a ❑Electric ©Other <br /> te,,.Iaed Q R-A� 01 L" Bore ;.. OMutti=remit 4of my ' <br /> Tytss oFro��f: QNsw QAddition QCommerctal Qtndu;trial .� <br /> DESCRIPTION OF'WORK: QRsmods( Qep3rr Oil. 051ratlkter <br /> o ❑Dsmoiifian QChat�.:oF U> <br /> epC9-A S v'\)1/4,roots <br /> AS30CIAT { Sort_ottia P"ERiVItT 4*"if a Enfeeble): <br /> [het"st4A-141l;.*Oliekiklit Ai?O tiCiiitii t a,t # <br /> Type of Prosect: _New M NG <br /> Addn ,Alteration x <br /> �Repatr t+�»�' <br /> Type of Project: NewyAlteration <br /> Lr'st flf�ft�rrs- #of Repair <br /> /C—Air Hand(it� Units' 2111111111 t s xtrrr° <br /> Forced Air Srst rtT"s ' _ -#- - <br /> 1111111111 <br /> 'has f'jpn* <br /> ImoUnit Heater Bathtub uan °' Pr +r $et Inside r . <br /> goiter urinal <br /> Water N tew La slwy(Was#�'S la) t3fitnl itna Fountain <br /> Ga rHaatee elft ratla)ri,, ho r <br /> INEININIM _ Woixi .tt vc tcftet stuklai .osat GFi Ceram <br /> allilli Grease Tno <br /> Man Ie thus-i;3 er.. iia�kfl ()van DIshwather' <br /> Rail 4ea Hood Other: Root't°ti ads <br /> Cions i Ie her A+fedi tCxa:s <br /> mum")statist Familan Water NeaterMt <br /> St`flic S' Suer <br /> Illinnialli JIM <br /> ( efvicet+8�rti�le� W#c,IMer <br /> a1tINKLER'i1=.`3tJk pftEsst Q 5 !'S.ToM ,,,' <br /> MIChemical or Water <br /> Nc.cf HeadsnIll <br /> �� <br /> ACKNOWLEDGEMENT:I have reviewed this application and conium the lnfomtaticn contained herein is trua and correct.Wcrk done pursuant tc this permit must co <br /> 1111111111111111111 <br /> current federal,state,and local law. The granting cf a paring only authorizes approved work and no deviations therefrom.Deviations must first be authorized In writing from the <br /> Building Official before late authorized under any circumstance.I am the cwrer,cr i am authcdzed by the owner cf this roe A mply with <br /> and I comply with the State Contractors Law 18.27 C CW and 296.200A WAC. <br /> property rty to erform the work for which application is made, <br /> CO,.off Everett Official Use Doty <br /> ° ► # P R <br /> IT • <br /> OW-erMir*horized A. Shore` ��• <br /> 01'1.0 <br /> Cite <br /> f+Revfsed°ea 1206)' <br />