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PERMIT APPLICATION
<br /> ‘1111°1711 - .
<br /> BUILDING I MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION
<br /> Nft1W4.3. '1 CITY OF EVERETT PERMIT SERVICES3200 CEDAR STREET,EVERETT.WA 98201
<br /> ;P425-257-88110 ( FAX 425-259-8857 }(E)everetfepsPeverettwa,gov( www.everettwa_govfperm
<br /> (Blue or Black ink Only Please) -i
<br /> PROJECT SITE ADDRESS: C }1✓0 ` [PROPERTY TAX#:
<br /> LEGAL for new axrstru on Short Platisutxlvrston for No.
<br /> ._- ..._ (attach copy of ong lege€tacerpttar€?
<br /> OWNER NAME: till a1/41‘ TENANT NAME(If Commercial!
<br /> OWNER MAILING ADDRESS: s-ores t .. .
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<br /> OWNER EMAIL:
<br /> tokt i' p NVIMATHVVORKS, LLC
<br /> =` C e,, 1 S24744TTH AVE NE
<br /> c ARLINGTON .ATE WA r r 98223
<br /> TRACTORPH 425-418-9545 :,ii',...ir,',ir'..,'":',",'-'i,'''Itibukw,i, N111BATHWORKS•r
<br /> CONTRACTOR LK:ENSi'' € '' NV'VBATBL855PA lorry OF EVERETT BUSINESS LICENSE#(REQUIRED$: 57184
<br /> PRIMARY CONTACT: , OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: "2 . 3z -2
<br /> > 1) 4 CONTACT EMAIL:
<br /> NIA
<br /> ,..� r OpucikytOtt
<br /> ESistnt .,A...,4:.,...::-..:':;','"?�. Contract Price of Work:$ $1100-00
<br /> Proposed Use of B ldln tleall
<br /> Said ,r.'• f ,d..i .-':* et,t+ 3' 'a B Nds '.!‘:i o7' ' •`k
<br /> '` ,tea> .- :.; TM t
<br /> T +- of Pr=`,W t ONew DAd iii€rn DRemod r[R:+air DTI. DSii,n DS*ninkler volition DChanie of Use
<br /> DESCRIPTION OF WORK;. ._..,
<br /> ,r--,,,,
<br /> ( &- ,.r ,.."--- ,,,5 /71 Com' ' ..
<br /> ASSOCIATED BUILDING RE MIT#(if a ble):
<br /> _ .
<br /> MECH AP CALL PERMIT A iC 4'1t1N... . ,7:''r4:'7';''' i :; � ...
<br /> Type of Protect: New , Adtrn Alteration Repair
<br /> of Is _ r F at
<br /> Fixtures List of Fixtures ik of List of Futures ' , Liar of Fixtures of ListMoony
<br /> Fixtures �� _ . Fixtures
<br /> r` ;heti ' Heat Pomp rid Backflow Preventer(Inside Bldg)
<br /> Forced Aar Systems Unit Heater Bathtub Urinal
<br /> °. ; •: Boiler Lavatory(Wash Basin) Drinking Fountain
<br /> aI t Refrigeration Shower Floor Drain
<br /> Wood Stove Kitchen Sink Disposal Grease Trap
<br /> IRS!
<br /> ._ Ducting Dishwasher Roof Drains
<br /> '11 ° a",.1 : � Other Clothes Washer Medical Gas
<br /> Raile Hood
<br /> •Exhaust
<br /> Fan Sink i Service/BariMo etc.I Other.
<br /> e ..
<br /> 'rli
<br /> �,.. ,. , . No of Pleads
<br /> ` F * ' **$ '*`"et a at a 1lf$• 14a40 a '
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<br /> --`''� Carr ' ?
<br /> 4„ , PERMIT#
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