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. . 'Y•]_ j� k�I I Vl Lva_....... _ _.. <br /> k; r' _ .- 3200 CEDAR STREET=EV-ERETT,WA 58201 <br /> 5 257-8857 E everelteps@everel �- =- I www.everettwa.gov/permits <br /> ----� (P}425 257-= FAX 425-257-8857 �( ) _.� __ <br /> PGROJIg. SII If f ®�E ATIJ® 1 <br /> $ (.v' I it '- f PROPERTY TAX# <br /> PRpJEGT SI T E ADDRESS: - <br /> ��`I <br /> 9r y Lot No (aitach copy of Long legai description) <br /> LEGAL.for nevi construction Short Plattsubdtvtsion , . : ... <br /> ` R _ E: • -- ,.' - I`AMB L(If Commercial): <br /> OWI�IER NAIVIC> TiT A 1--- <br /> 2101 0 I " TENANT', ,q e9 <br /> OWNER <br /> MAILING AI3Dt�E5S: sTREEr ,- si-ATE L . ; ZIP s <br /> CITY ✓1'C_.�'-•s-iv' <br /> �'�r %i OWNER EMAIL: <br /> • <br /> OVtIi�ER PHONE ��� �_ .. ,,.,, ,...� ...... ,,....... _.. . . ,.. ,,.,�. . .. .. .. <br /> _:. .. GTQR NAME: •-'1_1',C.-.-(: <br /> L '_� 7" J ' �e A� <br /> CONTRA <br /> CONTRACTOR ADDRESS: STREET ..t Zc) ✓dc.-=:4`L - <br /> STATE Lop. ZIP q q k <br /> CONTRACTOR PHONE: SZ� <br /> L5 Z'- CONTRACTOR EIVIAlL: 12-� -Ca L t�tri f c�G =C t�P�3 <br /> CITY OP EVERETT BUSINESS LICENSE�(REQUi:ZED}. j� <br /> CONTRACTOR LICEI\ISE :f(RERUIRED): �•- t:?. <br /> 2 _ a. ax "OP - <br /> PRIMARY CONTACT: Q OWNER CONTRACTOR N 0 OTHER(Please Specify) <br /> • CONTACT PHONE: 1, 2c 5e) - i-7 7 <br /> CONTACT IME: <br /> ti__-_,--; .-. ..A. <br /> CONTACT EMAIL .,,,,e...1-4....4 a�5j 1 L• - -- - <br /> - <br /> f Contract Price of Work: <br /> I=xisting iJse of Buitriing: rir leciric QOther <br /> iHeatSource: QOes <br /> Proposed Use of Building. Qtndustriat_ <br /> Building Type: QSFRDetached QSFR Attached QDuplex QMulti-Family-of Units: <br /> }-� <br /> - New QAddition QRernodet L7Repair T.I. ❑Sign QSprinkter1219 Iition v - QChange orUse � <br /> tYPeofProjeci: Q � �.j�(,�"' iJU �� <br /> DESCRIPTION OF WORK: „E '--- , C SIes A <br /> D k3UILJ3INC PERMIT (if applicable) <br /> ASSOCIATE ______ _ 11 . <br /> , .pi ( At411P-141:P1 • . ... —_- TYPa of Project: _[dew _Addn Alteration ___Repair <br /> Type of Project: _New•_ Addn Alterationnpair , f of #of List of Fixtures <br /> °f <br /> #of List of Fixtures ' fist of Fixtures Fixtures <br /> List of.Fixtures Fixtures Fixtures <br /> Fixtures Toilet Backtiow Preventer(inside Bldg) <br /> A1C-Air Handling Units I Heat Pump Bathtub Urinal <br /> Forced Air Systems Lavatory(Wash Basin) Drinking Fountain <br /> BoilerWI" Floor Drain <br /> Gas Piping I I Shower <br /> i Refrigeration ; Grease Trap <br /> Mater Heater Wood Stove Kitchen Sink&Disposal <br /> Gas Fireplace Dishwasher Roof Drains <br /> Gas Range Ducting Medical Gas <br /> Clothes Dryer Hookups Other: Clothes Washer Other: <br /> Water Heater <br /> Range Hood 'oiiiiiiiiiiiiimmiliE, Sink(Service/Bar/Mop/etc.) Other: <br /> , )111111111011,plumber of Headswith <br /> o deviations ruetherefrom.Deviations must lust to aurnper i rn Writing prow is me ade,' <br /> VDWLE1JGEiY1ElVT."thave reviewed this application and con�r hon'zes approved tvorlt and herein Is Eros and correct.Work done pursuant this permit must co�ufy <br /> ICK ofa perm! 017 urrentfederal,stale,and local taxi The grantingPr <br /> iuildicong Official before being authorized under any cciirrc�and 2362ernROR'he Ii owneAG. or t am authorized by the owner of this properly'o CitY o f V eW Ter wett Official Onpilhn, ly <br /> nd!comply with the Stat Contractors - T} <br /> j PERM1 n ) \,..... q.,, <br /> �� ? (Revise.5/2012078) .. <br /> _r�:...�r==ro <br /> Date <br />