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PERMIT APPLICATION
<br /> /, BUILDINGMECHANICA1PLUMBItiG'!SIGN I
<br /> SPRIKLER I DEMOIiTI l
<br /> �Y CITY aE ET PERMIT SERVICES
<br /> 3200,CEQA RET,EVERETT,WA 9.$2011
<br /> (P)4:28-$7=809 j FAX 42507-88E7 t(E)everatteps ev tt*goy I caw everettwa Wtperittits
<br /> PROJECT SITE ADDRESS;')C) , ; , l \j PROPERTY TAX*
<br /> LEGAL fir new; onstruction; Short,'Platisubd!iston , L of to , (attach copy df long tem descirtp n
<br /> 041104 . " t"#A'�
<br /> t...."01.:'4;-".:. �
<br /> ".-r g ;t uk ki�o � u"'' ,� • �,�iaa.„ � . . , 9 ... °' s � � .=.. -� < may, . , ji r
<br /> OWNER.NAME(1 ,\
<br /> tr"""""I,"'"'^ ) �,�h1Ah11`NAME(If i"rC?n►rrt81"Cl.11}. t
<br /> OWNER MAILING,ADDRESS." rsl r"—`i _I k \) ''"
<br /> CITY „�..� STA x11 ..
<br /> C VVNER PtiCINi , --- -;
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<br /> OWNER EIWIAI Ar
<br /> CONTRACTOR NAME:' \� P”*""a .. �;
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<br /> ONTRACTOR ADDRESS: ss t t I t 5` "'t V' �'., j • \ Wi t`
<br /> CITY p. :\ eriat r'—')4,-,""" Z12,..:? ,
<br /> CONTRACTOR PHONE "*..,°.1 ; i ra :- .CToR'E ' t 4404-.'b CITY- OP EyERETT'BUSING t3CENSE#(REQUTt"! .,
<br /> i"RIMARY CONTACT: 1:1 OWNER CONT ACTOR C OTHER-(Please-Specity)'.: -.
<br /> CGN t'ACT E:
<br /> CONTACT PHONE
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<br /> ,�_� _.a _fN 1 a . ,e_1. mld�'�: .ems 1 u, �*.
<br /> Existing Use-off ittitding;; Contrast"Price of Work:.$ �'
<br /> Proposed USA of Budding Heat Source: Iii .Die ti C Other r,
<br /> Building Type: CI$FR-O,etech E SPfi-Attacher! I7Dupiex 0Mlulti-Farrtity4 of Units: GICoMme.rola, Ind, ttst I
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<br /> We df Reojectt QNew C7Addition ORern del C7Repair Ott °Sign Morin'MetCiOemOIition ❑ han9e OOf Use:
<br /> i ESt RIPTI 1+OP VOR Et7 ,YM::', < \"*
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<br /> SOCIATED BUILDING PERMIT#(If appil'sabie):
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<br /> Type of Project:,,_,_,New___» Addy *Alteration: _Repair Type'of Proillet: �N Addn
<br /> Iteratic►tt —jZspalr
<br /> **.f List of Fixturaes l ft of Llst'of F#xftues all of List.vf Flxfutee- o/ List of F1xt%ires'
<br /> Fixtures FFxtures Fixtures Fixtures
<br /> NC—Air Handling Units, HeatP W p Tsilet Bat k lsw Preventer{�tnside B
<br /> Forced Air Systems tUtlt. ' ter Bathtub Urin
<br /> LSeale: (Wash Sash)- C ranking foontai r
<br /> Water.Heeter Fly Drei
<br /> Gas fireplace Stovei
<br /> ,. . Ktehen Sahli i•, Asp agar ' Grease T* p';
<br /> des R 9+1 ; Ducting C isttwiteht J 0 ,
<br /> loth O�:Hookups Off; 'ClothesWasher: tOas'
<br /> e H Wafer Neater Other:
<br /> �thaust Pan Sink(Service/Berl opfete.) Other:
<br /> Cher icat•or Water No,of Heads
<br /> AClcNV®ttif EDG'EMENT I have rev 4 thr ellptioadan and cerrrfim?iiia rnformatidit c inteined heroin-id true ani xcrreer. Wove ctmne pursuant to this permit mvst°cisrnpty mit,:
<br /> w�urrent federal,state,and lacallaw The;granting of a permit'only authorizes approved work snit aadevlatia as therefrom..Dawatrorrsmust first be ehathon'red Gr r crag froom the ,
<br /> atavttng omtcial bogie being.authorized under any circumstance i am.tttealwher,'Or 1 arta-au tett by the owrtdr oaf this property to perfrxrfi'thb work for•which application Is'rr a+e,;
<br /> end l c mpty with the State Contractors Gate 48.2'7 ACW and:206.4014,044:C..
<br /> Ctyof EverettOfFiciel Use Ctnty
<br /> PERmITAL
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<br /> own,.riAuthoria-'*Agent sititisture " bate;1 (Rot'4 s t 04372b )f r ,
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