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• <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> • <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-2578810 I FAX 425-257-8857 (E)smatter/ j a -I ,,eyerettwa.gm#Peill <br /> 131114;6 6 # :'else' <br /> PROJECT SITE ADDRESS: (Z t Y � � $ <br /> ..�. PROPERTY TAX#: <br /> LEGAL for now construction; Short Platisubditrialen ' <br /> Lot No.' (attach copy of long legahtlescrlptlon) <br /> OWCiIAM!IZIN 'a `x. '�#^ d'4� fi24Sp <br /> OWNER NAME. ar <br /> TENANT'N. <br /> bW. R"MAILING ADDRESS: STREET '" <br /> CITY .;4 a F_ ,... STATE <br /> ZIP .r <br /> OWNER PHONE: ,` d OWNER-:EMA . <br /> CONTRACTOR NAME: <br /> C NT ACTOR ADDRESS: STREET <br /> F <br /> IA A <br /> CONTRACTOR PHONE: ZIP <br /> 0 # CONTRACTOR EMAI „r; _ g r <br /> ;*t C NB=1Met 'i11 .o t <br /> PRIMARY CONTACT: 0 OWNER le CONTRACT4aFt• 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> �2J Led1-1-ZS 259 <br /> C 9 1TAEMAIL: m 4 Co*COtirtl <br /> pit as y <br /> adstin%.:Use of S,ttltdi 4 <br /> Contract(Price of Wor• k <br /> :,mast:,..ftstd,Use of etrtidl <br /> Heat Source; ❑Electric ❑Other <br /> p * . FR-Detached ❑SFR-Attached <br /> Ob *e ❑Multi-Famtl j ntte' =J <br /> ,,0 of act: 'ONew ❑Addition QRemodel OT.I, OS).rt Commercial f Use <br /> atrial _. <br /> DESCRIPTION OF WOR .T C>DemoNlion QL+1tt"fe of Use <br /> OCIATED BUILDING��y) PERMIT# <br /> x ittti A'a i T gpPE % g£ 1"Ty ;,¢C i 1 'S g� <br /> type of Project _New AddRepair n _: Alteration �';� ' � <br /> Type <br /> #Lotof Project _New _Addn Alteration Repair <br /> r 4 >•�f, :, of <br /> .n'< Air Hen/ . l�tt)at ; ��� Fl�hffes- `���� � <br /> Heat.P tn:° a <br /> F Air Systems Unit Heater. t Mater Inside Sty <br /> G <br /> e . UiCas P a Better Mash as ) 'T <br /> .(nWim'F <br /> 3s r ft n Shower <br /> Gas .. �T ce �� Stove ;E to <br /> Gas.Ra t Ki her3tt r:g tset Grease Tr.. <br /> Mott har <br /> Roof Ofain <br /> R ,a Hood �.- agtles <br /> I lW, O <br /> E <br /> Exhaust°Fan" titer' : <br /> Sink Se oeitilatifv1 a Qther <br /> 1 , 'I KLErt.`I S P'lleSSIti t Y-ST �• t <br /> Chemical or WN <br /> ater <br /> o of Heads <br /> 'ACKNOWLEDGEMENT:I have reviewed this application and confirm the Information contained herein Is true end correct Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of <br /> current Official before being authorizedlTh ,pafrrtil only authorizes approved work and no deviations therefrom.Deviations must first be authorized In writing from the <br /> lw 2ROWand 1the owner,ar 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply fialtb the State Contractors Law 18.27 ROW and ce,/296.200Aam WAw, <br /> Oita..., a <br /> PER <br /> City o..EverettOfficial Use. <br /> 1144. 4ietfx4d Shifatt?re., • <br /> • Caata: t . . rte ' r .A/ <br />