Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL 1 PLUMBING 1 SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 9ga■�: - }y(P)42�5y257 8810 I FAX 425-257-8857 (E) ).p,` ,avefe� �everettwa.govfpermtts <br /> *ASPROJECT SITE ADDRESS: s * ` <br /> � ." <br /> LEGAL fo new construction;Shod PtatfstiLt3�rlk) <br /> Let No• (attach copy of long legal description) <br /> • ',VONT* <br /> .A <br /> OWNER NAME• _. ,.. <br /> OWN MAILING ADDRESS: STREET , <br /> TENANT NAME{df Cornuefat�, " <br /> CITY <br /> '1-0......‘:A.°"24, .c";: STATE ZIP. a ; <br /> OWNER PHONE „r � <br /> b ;,. OWNER EMAIL: ' <br /> CONTRACTOR NAME: <br /> T�ICTt , "ADDRESS: STREET w <br /> CITY a " <br /> ySTATE". A <br /> CONTRACTORPHONE 3n 0 0 CONTRAC' EMAI <br /> � ;e � ► '- . � !l � •c�►, <br /> 1stws9Q: �1 ''' <br /> PRIMARY CONTACT: 0 OWNER le CONTRACTOR t1 OTHER(Please Specify) <br /> POI+TACT NAME: <br /> CONTACT PHONE � S251 <br /> e �n„ utJ <br /> CONTACT EMAIL <br /> r <br /> n - <br /> Exrs(t Use of htftY= - <br /> -Contract Price of Work: <br /> Use of Build',t, <br /> BIaIItfi: �, Heat Source OGas soft, El Other <br /> ladled OSFR-Attached $ t�'le8 ❑ <br /> TA‘,e of Idris , t, ❑New C)Adtiition C7Remodel � ,r P� - "-- QC4mmQrcial Otndustrial <br /> GESCRWI& N OF WORK:, L7TI. B '=fin el (]Demolition OCI of Use <br /> AS Q t- I'"ED;BUILDING PERMIT# e A 1 b1> <br /> Type of Project __pew ",. <br /> Addn __alteration _Repair" <br /> 34r�tf TYPe of ProJeet ,_„•,New - ' <br /> #isX _. _Addn _ teralton <br /> #of AI _Repair <br /> = wets <br /> ... " � � ��► t--�.••--..�M„�.;,.. ..,. <br /> fC—Airir �`�f Tq afi �fk n <br /> Pre ter <br /> t.I111f' eater (b <br /> Water Fdeatet= " Boiler J ars 0rik 1xrtf, <br /> {#as re ace . air <br /> Fountain <br /> mow ototles as ft- � Wt�wtt�'it#t � <br /> a Cio(h W bar t s <br /> Mcof as ,. <br /> MEMTaft'Fon INIMMI <br /> ate , >i Gas " <br /> Sink Saud arft „att. <br /> inimmumeemenuoilin <br /> i ftsup <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT. have reviewed this application and confirm the information contained hereto Is true and correctWork 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 theowner,or 1 am authorized by the owner of this property to perform the work for which appiicatlon is made, <br /> and I comply with the Slate Contractors Law 76.27 ROW and 296.200A WAC. <br /> 'Oily of Everett Official Use Only <br /> PERMIT <br /> M. %0 -003 <br /> ^a4k N/4' orl:ed :' #tttate' <br /> o to <br />