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IT <br /> APPL <br /> BUILDING / MECHANICALS PLUMBINGIISIGN <br /> (S <br /> 1 N /SPRINKLER I DEMOLITION <br /> iiiirW CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 93201 <br /> (P)425-257-3310 I FAX 425-257-835T I t ei rettepsaeve-e twa gov I www evar,.ttwa.gov/permits. <br /> (Blue or Black Ink Only Please:) "PROJECTS ITEAINF EC1MMlATIOM ` :" <br /> PROJECT S[TE ADDRESS: ea let . .-` . <br /> LEGAL for;saw orms±ruckian_ Shsaort r'et,3uaifsr�a M PROPERTY TAX#: <br /> Lot N (attach copy of long legal cbscnption) <br /> CONTACT4I=oRMAtiON '..• - <br /> OWNER NAME: <br /> s.--_,...* <br /> A. <br /> # TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: , 7cc) ,r# <br /> ilt <br /> At "STATE4 <br /> OWNER PHONE. 11 sa a# <br /> r OWNER EMAIL: <br /> CONTRACTOR NA16E„ <br /> CONTRACTOR ADDRESS: Ta=.Er 1 F5 Ir. root. <br /> 3TATa •, IIF- Zla s : 0 1 <br /> CONTRACTOR PHONE: � Ct 0 , <br /> SO CONTRACTOR EMAIL.:A.4 kt ill'C tkTRAGTt F4 LI F .•� LV <br /> CSCYCJrFf*RLT7UJtN,f L+1i`",za' r • MEWS'!i <br /> MPFCIS— <br /> PRIMARY CONTACT: 0 OWNER keteONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> �T}^'^C^ CONTACT PHONE: 4.zs 2 i ior-o o <br /> L�i�CJ�J Le, <br /> CONTACT EMAIL: . . Lk ., , . 1_„ L 0 .co, <br /> ExiatErs UsBof =EtUiGI»1►INGiaPEFMT`wt '�� `rZT " �`''v�; , rrr 'j� <br /> 8trt ding• f <br /> (Contract Prica of Work:S C 3Q <br /> Proposed Use of Build n <br /> 8at€ming Tyra: ❑SFR-Datached Heat Source: 741A s ❑Electric ❑Other <br /> ©SFR A Cached ODuilex ❑Muhl-Famil 4 o ,)airs: <br /> °i'yta3 of Project' ❑Naw ❑Ad:iition DR'nod,l � ❑Commarclal ❑Indu,tria( <br /> 3�ESCRIPT10N OF WORK: D _ it ❑T I° ❑>•' n I_7S r t fs !❑DsmoflEion ❑Cha iga of U31, <br /> a00 6---AIS-P1 let , <br /> 4.53G-ClATED elli DING PERMIT/#{ff a;ooii:aetar <br /> Type of Project: ANICAL PEItI�tilT 4PPLICt '' jQjq r <br /> 14'1�Cl�l <br /> T 4f' <br /> LUNIIIt+I+�,PRiVIsltll+l>!1:ttG1�TI tN <br /> New -__-_ Addn Alteration Repair <br /> 4 of <br /> - Pf urax t.i,&tst(_Ei�rtttres. #of #of <br /> r-Ixtu`r. 47(51xt:ue (,CSC Gf o 4UC8s' #of <br /> NCME - Handling Units Firluras �Ffxtlires -6rst-af—tures <br /> ME -Ci Air SystemsEMBEamas effaZalla Toilet —� <br /> ��®�� Mill Bathtub SarkfinE� Preventer(Inside Bldg) <br /> �� �Bcier Urinal <br /> Lavatory(Wash Basin) Drinkin Fountain <br /> R`frlgeraPen .Shower <br /> FWood Stove MINKitchen Sink&Dis.osal Greaseloor Drain <br /> mon Clothes b <br /> .............___1111111111111111111 <br /> Ducting <br /> Trap <br /> er Hookups Dishwasher Roof Drains <br /> Ra�anns Hood Other Clothes Washer <br /> Mei 1111111111111111.111111111.111111111111111111111.1 iin......IIIIIII <br /> .1111111111611111111111111.111111 Mil <br /> Other: <br /> .. PRINKLEKI-SUP RESBION SYSTEM '''• meg ti <br /> 11111Mtlanalin-leads 1111111111111111111111 <br /> °_ <br /> 111 <br /> Gh`1ti1GwLEcGEmENT•1 have tswawnd this a pticartaa dad car s".rn:the information collator,peter is true sod Correct.Work oar*dC�■ <br /> cum-eat fsdera$atara,and lccsllav The grar1trg cf a parnaf l RiJ authorizes g prcvarl <br /> nodding Cirrcial b rerbeing authorized order orrr:ur'tames,tam the'-own r, +vCtl 7,-* <br /> r d no deviafJcr theafrcm,LL evlsticfs roue,first z fled ed wNRr Y vrrth. <br /> 1 ctmoje with the State Ccrzttactcra Lase 7eiz7 E-r••r, s_ or <br /> l arr.a+it};cdZed ti lite ct .eirct this rE e rr na il:rs <br /> v”sre?e�u.�Cei-INpSl;,. X� !w+i5!Ira pork=th.9 wort which ac-ifcaff,r,is murk <br /> CNy cf Everett Official Use Only <br /> :4.a I kCa PFiMITt} n <br /> Ow,eriAulhorized Age• 6Itmature I <br /> ''-' atn <br /> (Revised 9 3/206 <br />