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<br /> cm(OF EVERETT PERMit-s ues
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<br /> E *- S8201
<br /> ------ ., .. . ., . (p)425 V4. 3200 CEDAR STRET EVE
<br /> 810 I FAX 425257-8807 1(E)evemaePs@evz-...”:"a.gov 1 www.,everawafloviPerinfts
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<br /> it 44#14are:INK1i)tAti Wii44) . ..- .., 0,44.3 PI.MIMI Nigifilierkik :: . •-* :: * - *- ' . - - . :.'-- -
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<br /> PROJECT SITE ADDRESS: ti-w thi-gwa itee. . ie_ !PROPERTY TAX#:
<br /> LEGAL for rtew COTIStiLIGIOR: ShOrt Piatirsubdiviston
<br /> 1----
<br /> _____ _
<br /> Lot No. (attach copy of iong legal description)
<br /> __ ___
<br /> — _
<br /> 1'17:;;,".:: '4 '''' ' '7:'` ..".1.'''''•''.'-'''''" '' -."" " :.' .:' ..ttiOriegdfier011 Viteiti ' ' —.'' •*'''''*..I.-' s ''''''.':. ' .*** * * .T1' :''t
<br /> 1#3ralr. .
<br /> OWNER NAME: jr ilk, A t ' TENANT NAME(If Cm-mere-ail:
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<br /> CANNER MAILING ADDRESS: sTREET cz Z_O 4z3 14
<br /> 2 66,-
<br /> 0 &TAM ICA c ZiP 40 '''' .
<br /> -'
<br /> OWNER PHONE: goi e 5 - OWNER EMAIL:
<br /> CONTRACTOR NAME: 601:, ,,,,..1 •:---co , .0/ At't
<br /> CONTRACTOR ADDRESS: STREET OA ZO A-CA_ Lc....
<br /> STATE. LOA Z/P 4 V20(
<br /> CONTRACTOR PHONE: H-2-5) 1-52-- .51.114- CONTRACTOR EMAIL: 1-,--e_----q/1-0.,X:15.5,'fill tc...V.Z..e- ,1
<br /> CONTRACTOR LICENSE#(REQUIRED): -C-vael .0 44 • CriYOF EVERETT BUSINaS LICENSE AREQuIREDJ: 6,la
<br /> PRIMARY CONTACT El OWNER in CONTRACTOR U OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE
<br /> 1"---0 6.3 oki r? CONTACT EMAIL: x tit-d.a 6*5"ltiAa. alin
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<br /> kikiviit*.APPETiem reAt •** '—. .
<br /> • - •
<br /> -: '-`• ***•-•: ..'*-'" : ' ' ' '
<br /> • . * , ; - -
<br /> Exiserng Use of Building: Contract Price of Work:$ 17
<br /> - Proposed Use of Building: !Heat Source: °Gas 0/Electric °Other
<br /> Building Type: , FR-Iletached OSFRAttached [(Duplex 0Multi-Family4 of Units: °Cornrnerclal °Industrial_
<br /> T pa of Project [(New EfAcidition DitRernodel °Repair °T.I. DSign °Sprinkler tkernolition ElChange of Use•
<br /> °ESCRIPTIQN°F W°RK: 1-;"SI- tl---4-1 ' -1.--) ''''' — )-- I)C4„4,7,c 1,-(.. 'S Rem Pt.4-tilt Sy
<br /> ASSOCIATED BUILDING PERMIT t iLf al2fLI lcable): _ _ ,, _ _ _ _
<br /> itiWit.4.4AW:01: ' ' - - - '"*. :. PlilAd 02 :11.4011-KOAVO44 :` — •
<br /> rip of Project: New Adder Alteration ____Apair , , Type of Project: , Wow Adrin Alteration ....____Repair
<br /> t ,
<br /> 0 ofI 0 of ' #of #of
<br /> . List of Fixtures ! -- List.of Fixtures Fixtures •
<br /> List pi:Fixtures
<br /> Fixfunas 1 i-ixtures , Fixtures i Fixtures
<br /> NC-Air Handling Units !MIN Beat Pump :MN Toilet liallin Beddow Preventer(Inside Bldg)
<br /> Forced Air Systems _ jallallME31111111 MIN Bathtub 11M Urinal
<br /> Gas Piping . i Boller MIN Lawton./(Wash Basin) ; Drinking Fountain
<br /> Water Heater 1 kefrigemtion AIM Shower : Floor Drain _
<br /> Gas Fireplace 1 Wood Stove AIM Kitchen Sink&Disposal ' Grease Trap
<br /> ,
<br /> Gas Range 1 Ducting 1.11111 Dishwasher • 'al=Roof Drains
<br /> Clothes Dryer Hooke is Other: • aillIN Clothes Washer :MI Medical Gas
<br /> Ran 0.0 Hood 11111111111111 MIN Water Heater 1.1111111 Other: —
<br /> erhaust Fan 11111111111111111 11111M Sink(Service/BariMopteta) lalli Other:
<br /> 1 1
<br /> 1101.1111111111111111 ,11111111111111111111111111111111111111111111111
<br /> •••••••4 ':TSN 41:< 1# 1S11001Yt : . -,.:. 1111111 1.11111111111
<br /> Number of eads mmolow
<br /> 'IIIIIIIIII11111111101111
<br /> ___ _
<br /> 4CKNOVIILEDGEMEN7:I have reufewed this application end wenn the information contained herein le true end correct.tilleVIC clone pursuant to this permit must comply with
<br /> :orient federal,steles and local law.The granttag ofe permit en!yauthodzes approved work and no deviations theraftint.DeVetions must first be authorized In WOW fitO1 the
<br /> VI/ding Official before belly aulhodzed under any circumstance.i ein the over;or 1 ant authorized by the molar of this prOpeny to perform the work for which application in made,
<br /> lid I cony*with the State Contnitiors Law lit •. and 296.200A WAC. •
<br /> City Only
<br /> / FERMI AT ri ' 1
<br /> S sp ir Lri\ 663-6(0.--1
<br /> ,. ., • ........., „.„..,.,. legrtafr wet% Data (Revised 6/20/2018)
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