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BUILDING /MECHANICPERMIT APPLICATION <br /> AL I PLUMBING t SIGN I SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> _.... X3 00£EDAR STREET,EVEREST.VSA 9201 <br /> (P)425-257-8810 I FAX 425-25T 8857 1°16 <br /> �oar� wwwev r�ttwai <br /> � <br /> oviperm <br /> itstB e II taat - 1,I t � r _B r �.-, ., <br /> PROJECT SITE ADDRESS: . <br /> 'a. ' PROFERTY TAX r#: <br /> LEGAL far new construction: Short Platisut:dlvls{dtt <br /> #otNo.` (attach copy of long legal description) <br /> OWNER NAME. .• <br /> .:: c ,. a ,‘,..4% TENANT NAME if:Comm Istf a <br /> OWNER MAILING ADDRESS' <br /> .... CITY • a 80, STATE ` ''' .lP� <br /> OWNER PHONE :: <br /> r, OWNER EMAIL: <br /> CONTRACTOR NAME: ' , <br /> CONTRACTOR ADDRESS• yy <br /> ,... <br /> _ crry <br /> r� STATE LIP <br /> CONTRACTOR PHONE Ve <br /> � —I f� 0- <br /> CONTRACTOR <br /> A ` Lam' <br /> !RIMARY CONTACT: ❑OWNER &. ( Specify) <br /> CONTACT NAME: CONTRACTOR 0 OTHER ecify) <br /> �A+A�^ CONTACT PHONE 2.5 2.5 C- <br /> CONTACT EMAIL <br /> �Use of� i�tln .: <br /> Contract#Hoo of Work:* <br /> Propo ® Use of R�ttlrr <br /> wit f#ss�' Heat Source e <br /> .0 � . ,OBER Attached CID,.(pc C7EIecMcQ ❑Other <br /> >L6,� t I ' a units Comme'rcial Oindusfriel <br /> TAS of QNew.. DAdditIOn CCtemodsi QR. 0 <br /> CRtPTION OF WORYCs ,x fr , CIT[ Mi. 1'1' „ „ <br /> < I! ODemolltion Qch ;''A of Uss <br /> , 'S )),e_v\e-a.es4..- G.-20\s -Fui:Z%ea.csz.._. <br /> ASSOCIATED BUILDING PERMIT# it?. Lica ;•>,,. <br /> A <br /> of Project _New ,-. <br /> ,.,,,, Addn `Alteration ;_Repair <br /> Type of Project: <br /> s _ # Addn _Alteration _Repair <br /> 1 ? NieenittiaaiiiM s #ef;. <br /> G Air �iltl A Lttxt >: i <br /> mato id t '- teles- �st,Ptil Toilet <br /> owl G. r= asmotyL f }eater " mit Prgventer t :>a {d.$ <br /> am(Water:teeter' aIM d�av4Ct3 t1 <br /> oar <br /> mos <br /> 4111111111 it:L * '11-61161 Nagel Woody . <br /> T7i <br /> �#t t;�:fl at <br /> e ta. a+> her <br /> ks3 Fan t'' ef <br /> e <br /> s nii&nail er7 <br /> 11111.1Eill€ <br /> 1111111-ttrxait or Water <br /> No of Heads <br /> Inill <br /> `ACKNOWLEDGEMENT'1 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,slate,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.1 am She owner,cr!am authorized by the owner cf this property to perform the work for which application <br /> and I comply with the State Contractors Law 18.27 RCW and Z96.2t WAC. <br /> is made. <br /> -, - City of Everett Official Use Only <br /> O. a!Aq ed:fl atura +ter ....1 PERMi # <br /> bate.._ <br />