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PERMIT APPLICATION
<br /> sOBUILDING I MECHANICAL I PLUMBING t SIGN(SPRINKLER I DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> - :425-257-8810 j FAX 425-257-8857 I J ever g p arattwa,gov I'www.everettwa.govfperrnits
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<br /> PROJECT SITE ADDRESSy,"' at�. � � �
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<br /> 'LEGAL ,cuc ion• ShortPlattsu .�a.. � � it
<br /> PROPERTY TAX(€:
<br /> for new cantbdw 'nn '
<br /> Lot No" attach copy of Ion legal descriptio
<br /> WaER NAME: •
<br /> CONTA T N R' ' ON i f
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<br /> , TENANT NAME If Commercial;
<br /> OWNER MAILING ADDRESS: sr94;249 ' ' (41," feet
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<br /> OWNER PHONE; . .....„..,A. ,, ,,,, STATE •...4 ZIP '
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<br /> OWNER EMAjL;.
<br /> CONTRACTOR NAME: a
<br /> CONTRACTOR ADDRESS: STREET 14
<br /> CITY ,.
<br /> STATE , Z! • : , 0,
<br /> ON',' RAO° oR,PHONE q CONTRACTOR
<br /> CONTRACTOR 0 O ,- ,, .� ', •. ,„i,... � ..4,..10„.,... a
<br /> PRIMARY CONTACT: ., '
<br /> 0 OWNER
<br /> OTHER(Please Specify) :..
<br /> CONTACT NAME;
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<br /> CONTACT PHONE: ,
<br /> L2, 25 OSS
<br /> CONTACT EMAIL ', . ;
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<br /> Extstrrs* Use of BUildirriii.
<br /> Contract Price of Work41P
<br /> Pits.tas��d•Use Of f3uildl;'�fi
<br /> Prtl T , Heat Source:, OGas eat. ❑Other
<br /> pe '-Detached ❑SFR Attaced Clapp*: DMuiti-Famll 4:.of Units
<br /> lCommerctal 1Z/industrial.
<br /> Tfie of Prj t• QNew ❑Aifion ❑Remodsl OReosit [ T.I. ❑Sior13Stirfrikli.r :CDsmolition €a wof UseDOCRIPTION OF WORK:
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<br /> srAAPpt
<br /> Type of Project `Neyr� Addn Alteration
<br /> If af; `Reps( Type of Project _New
<br /> �Addn Alteration Repair
<br /> ', aftifas • - #of
<br /> -Air t°t8nls#1g:Units ' �##
<br /> man Forced Atr ; Heat Rum
<br /> Estes Unit Hoofor
<br /> bathtub �€ty��I�� � �t i � j��'
<br /> ` Heater , LES_ O5it s €. Dru k tlf Fountain
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<br /> Chemical or Water
<br /> OM N. of Heads
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<br /> f Everett
<br /> Official Use Only
<br /> 1iPERMITf0u . 2 • rra' a Authorized-Asp . ature Dale
<br /> ii (Pavia-._ °"... e 61
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