Laserfiche WebLink
PERMIT APPLICATION/SIGN <br /> /e <br /> llIPO"414, BUILDING/ MECHANICAL!PLUMBING I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-267-8857 I:( everettepeoeverettwalav I www everettwa•pa+tiPeernits <br /> y <br /> PROJECT"SITE ADDRESS: R - <br /> -, r" A .. PROPERTY TAX#: <br /> LEGAL for new construction: Short Platttmsu'bdhrlsierk <br /> t;.ct No.` (attach copy of long legal description) <br /> A .. . TENANT NAME if Co <br /> OWNER NAME: t � a ._ <br /> omTnet (al). <br /> OWNER MAILING ADDRESS: ' STREET B l 7 0.,,,,,,', A <br /> CITY am 41 0019411 STATE <br /> OWNER PHONE <br /> = ;" � OWNER EMAIL:.. <br /> CONTRACTOR NAME, <br /> CONTRACTOR ADDRESS: STREET <br /> CIrY ario e ' - " _STATE l *' <br /> ZIP : a <br /> CONTRACTOR PHONE: <br /> ct 01$1, CONTRACTOREA1 ' ` ,4) 4 „r 0- 6.:; g r '` <br /> a 'V •is4i -1�1 "afi EltREOI<ll�, IIS 'L atie i 6° vain' -t 'F"SVeRer &tt004r0'fi CE0gi '#(-+-n' -4t.. r' f* .; <br /> RIMARY CONTACT: 0 OWNER 10 CONTRACTOR 0 OTHER(Please Specify), <br /> CONTACT NAME: <br /> D,,.,,����gg��e= CONTACT PHONE: 2.5 25 O <br /> eO <br /> CONTACT EMAIL , 1,A I 0 a► Co* <br /> I <br /> Exlsftn® Use oflttttdln+ <br /> Contract Pt a of Work. t 10 • <br /> Pro•oSed Use of;Suitt#1nm <br /> Heat Source: Das i rte 00ther <br /> Staitttin=7 +a„ FR.detached DspRAttadhati DD .lex DMtlitl.Ferei'4 of Units: ❑Commercial ❑Industrial <br /> T +e of.;l act: DNew ❑Addition CI Remodel LIRe'alr DTI D .!n DS.ril'Ikier EI Demolition .DCtIII A.:of Use <br /> DESCRIPTION OF WORK: <br /> (11,6- iS(l, d *-Q <br /> ASSOCIATED BUILDING l <br /> p� �+g 'MIT# :�s€#:pticebte;,;'., <br /> r M Et4 t:0 4ItriF� tiOA t il'�t10 rY#?s`°P s tk SII ,� r <br /> Tye*of Project: __New q.<'��a r"� � . ,ij{ ,.= <br /> w,y Addn Alteration Repair Type of Project: New Addn£ Alteration <br /> #of _ ._ <br /> _,4F < #of #of _Repair <br /> . <br /> LL , . f=ix tTFs LISA'OFFlxllitf is #of _ "..r. <br /> r ' <br /> Ate.—Air HandlingUnits Fixtures.. <br /> � 1 kHest Pump . 'Toilet <br /> 81E17— <br /> 'Forced Air:S Systems �: (re rater [Heide f}il <br /> � Unit Heater a1tiNaFi <br /> Gas Pi.: ." � 'boiler � � t <br /> 11.II <br /> water Heater aClr� gll ►t <br /> tri.Grattan k <br /> Shower Floor <br /> e. taGasPi + .c, . Wood t Idclat Sink&Disposal Grease traaC Ran.e Dui. ! esker o f <br /> sCkc pa:0 er Hookups OtherClothes Washer tothoaI Gas ama Nom <br /> Water Heater - <br /> EtTausten I ! <br /> „, . Sink.SS VIC8 Brain°/ t <br /> 01 er ' <br /> i ir' it u I IO>N,s ,,TEr ��. <br /> - <br /> Chemical or Water <br /> No.of Heads + _ <br /> ACKNOWLEDGEMENT I have reviewed this application end 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 end no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.1 am the owner,ort 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 /> Cilyof Everett Official Use Only <br /> ET '\ <br /> SO4 ^04°J <br /> ow, r/Authorizod AilStljatZre <br /> Date tI <br /> (REtVIs :otz„fal$) <br />