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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 tE),Oye.rettepageverathea4gpv I <br /> www.eve"rettwa, <br /> ovp <br /> poetts <br /> talO14'41i BlackIkkbttly-Please _; R j S I , r , ° ,r , , e . x_ : 'PROJECT SITE ADDRESS ' <br /> aIIIIMIIIIIIIIIIIIIII <br /> LEGAL for new construction: Short Piat/sti PROPERTY TAX#: <br /> bdfyision Lot No.:______ (attach copy of long legal description) <br /> CONTACTt t)l os, 1` ", <br /> OWNER NAME:. vii# Ir > 401^, <br /> TENANT NAME(Jf Commercial; <br /> OWNER MAILING ADL`FRE SI STREET 120 veto <br /> cnYrr,:. t 'CF <br /> OWNER PHONE: _____._ <br /> "` ,, ,.'• STATE ZIP 6 dm ' 0 ala OWNER EMAIL: <br /> CONTRACTOR NAME: , <br /> CONTRACTOR ADDRESS: °` <br /> ... STREET � ` ::. C L% dko <br /> CITY .: STATE- zip �° :. <br /> COiVTRATiF{PHONE: A :�, 0 I <br /> . <br /> �. ,O _ CONTRACTOR E AJ • a , " <br /> £0 <br /> .,' ei� i� aw rroptvEn..ty If+ S1 tioeNS <br /> PRIMARY CONTACT: 0 OWNER 6 tEQfJffiED) rw <br /> CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> �,,���J CONTACT PHONE J Z5 '2J O <br /> CONTACT EMAIL <br /> ye10015 Cor)el <br /> s �Ft( qqqy �+iyy�,�,r a-��^!'"' YtOtOf � �� <br /> ^a <br /> % <br /> !sdeett Use of Buii�iin� - '>- <br /> Contract Price of Work: <br /> Proposed Use of Buiidi.4: r. o ...At <br /> Heat Source: 4. <br /> gttli�itab T •e. �.FR;i�ettached ,s ❑Electric.. DOther <br /> O � Berl OM.lex CU4t ,. amii .�>.of Units: W <br /> I we of)�ro"ec{„ pNe1,v pAddition -- — �7Commercial ❑industrial <br /> DECRIPTION OF WORK: C1Remodel ❑ie�alr lIT•I< �a EIS. *Neter- <br /> C1Demolition ❑Chait4e of Use <br /> Rqietttli 5 Aft, 441 s. , 1^ <br /> v <br /> `ASSOCIATED BUILDING PERMIT"#;If:.plioatlle <br /> MECHANICAL PERMfl' APPLICATION,, ?. <br /> Type of ProJect. _New �$ t .'�� ��,�'� �'� �;� � •�r ��� ��Irt� � IN <br /> Addn Alteration __Repair <br /> #of { { #of Type of Project _New ,gddn Alteration _Repair <br /> 4�t .Y".. _-.,^^-- food. _A;, _ <br /> #of111111111111 f'l�rttrPes #of _ txthhrer ,.•�.... , <br /> MC Air 1=fefa�lilt�a Units• Meat Pump -� liras <br /> Fo�if it Syr terf sBatlt Urinal .Ptavgrtler inside Bids <br /> Min unimaINMILGas T'iIiia Unit Heater- B�Itt <br /> allialli filer Uri <br /> ( aSh Basin <br /> #�efrl�eratlP� .�`< Clrinklra i^ouTeletn <br /> Nun Wood Stove Shower n Floor Drain <br /> 1111111MEMMIL=Inisis RIM Gas Ran.. lichen tic&OI asst Graase ra r. <br /> MIMI CFiofhes 0. at`I tsaltaps Otho # Blattetr <br /> asimmi Cane Hood i s Wish' cDrains <br /> it?Iti Gas <br /> 'urate`Ilea a Other <br /> Otfa :alliali : <br /> S Rzsj<ER-SUP#R>_SBtOM Sif`B'T'EM ;p <br /> Chemical or Water Mil No.of Heads <br /> 11111111 <br /> 'ACKNOWLEDGEMENT:l have reviewed this application and confirm the information contained herein is true and correctWork done pursuant to this permit must comply with <br /> current federal,stale,and local law.The granting of a permit only authorizes approved <br /> ust first <br /> ed <br /> m <br /> Building Official before being authorized under any circumstance.1 am the ow e,or am authorized by thework and noons owner of ttherefrhis s property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW end 296.200A WAC. <br /> City,of Everett Official Use Only <br /> . erJAullhorixed Ae _! t t f � V <br /> y $o - <br /> tDate <br /> OS s <br /> t`le fst d _ftS'} <br />