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-•. -Mr-igerr 3200 CEDAR STREET,EVERETT,WI 01
<br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettv. u-V I witm.everettwa.gov/permits_
<br /> -77-7-------- 7:;77--- . 7'-- --- --7:- .rem-tio.mAigi5C • ...' --*: '-:-- - . - • • • •••• "*.. .-.:• :.:
<br /> 15.114cN AA PraiY F.1[50-..6) • ,_:.__-. . 1?11MJ11 APC: ( -,„ __
<br /> PROJECT SITE AI3DRESS: 0 1 t
<br /> LEGAL for new construction: Shod Plat/subrliviston____________Jot No.__ (attach qopy of long legal description)._
<br /> ......__ -- -------_ ---------;--:----- ---- .2 ------.--;--------- -:-. .:::-; -- ----:-:----"•-":T-,--.-
<br /> '',":. '''''..' ' ... : : .'..':. .." .... • • 7;" • • ":, •061011APT gebIRMATIO : • .. :; :. . : .L.: :: . : -: ' ::::11.2:,..L__•,_,.... .
<br /> , .
<br /> OWNER NAlliIE: /• it A ILI .it/
<br /> as 4 . TENANT NAME(If Commercial):
<br /> , i,
<br /> 4
<br /> OWNER.MAILING ADDRESS; STREET IOC) g A -1:,;0'r we IA7 .,-1 IL,.• A ------
<br /> -------- ,
<br /> CTTY ier me . STATE VI
<br /> -----:-------
<br /> WNER PHONE:
<br /> CONTRACTOR NAME: tri)e,','-'-,t- .„.1 ,---.:',
<br /> _
<br /> CONTRACTOR ADDRESS: STREET 2.12.0
<br /> ---- CITY -
<br /> _ STATE U.911/2 zip tiV2o k
<br /> COgriR,ACP1-1°1\15: ‘t•t2,5
<br /> - -52-- CONTRACTOR EMAIL; t.24-0.-)" (4,...a...AP:-Se- inel t4.)a.,...-ei...9•
<br /> CONTRACTOR LICENSE#(REQUIRED): k,-;.--,v- ..-(2 4,,se., _.,,,_ ,- .....,___„._.-,:m ‘, !.rly.,?1E.,,,.VE_R,E_TT.,,,LUINESS LICENSE#(REQUJR2_D):1V.
<br /> PRIMARY CONTACT: El OWNER li(OONTRACTOR 0 OTHER(Please Spedfy)
<br /> CONTACT NAME: . CONTACT PHONE: Las- 07
<br /> VE----(.-3 C-:1M--0 CONTACT EMAIL
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<br /> --% ''-‘-'-' -- • - • :. • . • - ' : llJILDINO PERM11.APPLICATION ' :. . -- ..-.: -.• . • -.... • - :.
<br /> ___ -___ ____ ______-
<br /> Existing Use of adding: ° al fir
<br /> Contract Price of Work;$ '_.__ ____ -_-----
<br /> Proposed Use of Buticling: IHeat Source: FA, as LiElectric EiOther_---_
<br /> Building Type: EISFR-Detached DEFR-Attached „EIDuplex EiMulti-Family4t-of Units: .,_commercial Clindusfrial
<br /> Type of Project in New OAckfition EIRernocret epair Err.i. Elsign Els orinider inDernolition EiChang s of Use • _
<br /> DESCRIPTION OF WORK: Rqk,k66-, :3,,46
<br /> U. ....N i-1- Li..2/t...) ,
<br /> ASSOCIATED BUILDING PERMIT (if
<br /> "'"----"'''r'''''''.-- :" . *,%*'''''"-' -"'..-----":" -'-'—'"--- -'"- ••-.. "- ---- 7 •
<br /> 7s Lilditiiikra.011CheaggK '• - -• '-.. I ifikiirthi.M0 litritillr.4),MCOATJMN ._ _______,_. , • .,
<br /> Typo of Project New. Arida _AlteratIon _Repair _ ,_ Type or Project: . New Adrin _ Alteration _Repair
<br /> ________
<br /> -...---- ---:---__-
<br /> 0 af , 0..4 of 1;-1 of tl of
<br /> List of Fixtures i List of Fixtures Fat- ures List of FIXilITOS List of Fixtures
<br /> rixtures ! Fixtures Fixtures
<br /> _.----
<br /> -
<br /> NC-Air Handling Units Heat Pump `---- Toilet Backflow enterirUsic_ f r g
<br /> ---4 -- -
<br /> Forced Air S stems Unit Heater -I 1 Bathtub Urinal
<br /> Gas PipingBoiler Lavatory(Wash Basin) ! Drinking Fountain
<br /> -_--
<br /> Water Heater Refrigeration Shower 11111111111 Floor Drain __ • _____
<br /> Gas Fireplace Wood Stove Kitchen sink&Disposal 11MM Grease Trap________---
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<br /> Gas Range Ducting Dishwasher . i Roof Drains
<br /> -- li=
<br /> Clothes Dryer Hookups _ ,
<br /> Other: - Clothes Washer _ Medical Gas
<br /> _
<br /> 1 -
<br /> Range Hood Water Heater WW1 Other:
<br /> ___. imi Sink Exhaust Fan , Service/BarIMoideta)i
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<br /> 111111111
<br /> -_--_,-------- 1 .....•.,.."-*"........................... M,r..... - ...
<br /> .7 ..0 '.::'511:kii\fiar411-.Q.tit( VisibA- 'cipTEivi. . -..j
<br /> -7:..L.:-:,-:_::-•:---; ---:-----,_.__---,, .._.___
<br /> Number of Heads
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<br /> 1CKNOW/..EDGEMENT:I have reviewed this application end confirm the information contained rein'shetrue and correct.Work done pursuant to this permit must.,c.omplywith
<br /> Zurrent federal,state,and local!eV/.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations Mat first be aurhonzed in;wan g from,he
<br /> 3olIding Official before being authorized under any circumstance,I ain the owner,or!am authorized by the owner of this property to perform the work for which application is made,
<br /> City f
<br /> rid I compi ly with th Slate Contractors 7 RCW and 296,200A WAG.
<br /> ii ( . 4,4ig PERMITM .
<br /> ,oEverett-Official Use Only
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<br /> a 0 OkA -02'CP
<br /> J ____------_,.---. (itivisecT5120 -----------------------------------
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