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0001.00, <br /> PERMIT APPLICATION <br /> BUILDING 1 MECHANICAL/PLUMBING 1 SIGN I SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8$10 { FAX 425-257-8$57 ( E eve, <br /> (Blue or lack'I k'Only Pl a :), 4 i� tt+ e v l www.ever,,i, , , ,e i t <br /> PROJECT SITE ADDRESS; a <br /> LEf.'al,L for new construction: Short Plat/subdivision PROPERTY TAX#. <br /> L,Ot No. ,, (attach copy of long legal description) <br /> OWI EI NAME: a C�"L"NT I ; ftiN ''''',1:-; r <br /> `` it i . "-. TENANT NAME tf Comm dfaf) <br /> OWNER MAILING ADDRESS: STREET <br /> ill <br /> CITY a ' t <br /> STATE dr ''• ii <br /> OWNER PHONE: 25 330' ' C} s ZIP <br /> OWNER EMAIL <br /> CONTRACTOR NAME; <br /> CONTRACTOR ADDRESS: ,ev <br /> STREET l 4" Q •. <br /> Gin ,19+, ►,` ar <br /> OONItACTOR PHONE: srnti A. ziP- 0 1 <br /> . q Q CONTRACTOR EMAIL• i , -,•s <br /> " II4Id�RY CONTACT: � <br /> 0 OWNERrte; .. <br /> CONTRACTOR L�OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: <br /> �2b�S0 cst. .� 25' <br /> CONTACT EMAIL , <br /> EDJ$ <br /> ExIst3Tt Use of BMtidln*: �' . `�. � �� <br /> Contract Price of Work <br /> 'itposed Use of t3ulldjn , <br /> Sunil► T Heat ifrce: i'mss ❑Electric ❑Other <br /> , FR-Detached O i Attached OM,tax M t Itf of Units; <br /> Tea of.:t roe, DNew OAddition DRemodel OSSIan O #rlrlkier D pon D era t ❑Industrial <br /> DrsteRI a I OP WORK, C7Re�air QT.!. Demolition OCha a of Use <br /> js ►"iet4t-G2. <br /> ASSOCIATED BUILDING PERMIT#.TNei);lldable; <br /> Type of'Project: _New ..... r 4'. f 7 a <br /> Addn Alteration Repair 3 � MiIt tl � .. <br /> *Pe. Type of Project: ,-•,_New „Addn Alteration _Repair <br /> m os �i-t# rizt ft #o <br /> : <br /> _ b' � —µ-- <br /> - <br /> own <br /> NNW .fresFfxtiresArfO-AIrHendii 4- 3t[ts Heat parva TiTerl8acPreuent r Ir ad 'lido"OtCed r Sys-ten-la Jnt leBathtub aliGas 3in$ IIIINIMI Eo3Ir Lava-to Wash Basin rrk Fountain <br /> Hafernini <br /> IIIIIIIII <br /> alliall <br /> NM Gas P}rashes Refti a tisk Shower <br /> rsP <br /> Vie Ranee <br /> NM Wt d•:Stove tehen Sink Dia. Floor Drain <br /> NMI tucltn a Graeae a` <br /> Curti ss 0 er oaku+s OtherMIMI Ciathes_WaeiShwashar R i"Drains <br /> IMM Medical Gee <br /> I,xhet Eert -tor�atr other <br /> 'mice Ear ";e e. r <br /> MRChemical or Water <br /> No.of Heads IIIIMIIIIIIINIIIIIIIMIIIIMIIINIIIIIIIIMIIIIIIIIIMIIIMIIII <br /> 'ACKNOWLEDGEMENT'I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,stale,and local law.The granting of a permit only authorizes approved work end no deviations therefrom,Deviations must first be authorized In writing from <br /> Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application <br /> the <br /> on is made, <br /> and I comply with the State Contractors Law 18.27 ROW and 296.200A WAC. <br /> € /,f Ci/yof Everett Official Use',C;rliy <br /> 1-1.1(1PERMIT ' <br /> O' ^er •txthtsrCxatl,Atte Signature <br /> Date <br />