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05/16/20i6 MpN 13:29 FAx Fa�t water Heater �003/OOa <br />. � <br />�RM1�' APPLlCA�`Yt� � 2� . _ <br />BUILDING/MECI-I,ANICAL,/PLUMBING/SIG(V/SPRIN�CLERlL�EMOLITION <br />CITY OF �VERETT pERMIT S�RVIC�S <br />3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425�257-865� www.evereitwe.org <br />SITE ADDRESS: <br />L Por new Constructlon_ Short Plat/subdlvly <br />�� <br />PPLICANT: _ Owner _ Owner's Agene � Cantractor <br />oNT��TOR �� � t�� ��r�� � �-I-�,�-r <br />idrees ( � � �� � �,12.�.�� ��KYULI S�� <br />°NANT BUSI E NAME "—' <br />BrJILDiNC� P�RMI'1' /►ppLICATIQ� <br />Existing Use of Bullding <br />PROP��tTY TA� f! <br />ci�y�is���,z�p <br /># <br />� <br />No, (sttqch copy of lanfl leg�l deecrlptlon) <br />yas�� o ��-�� � <br />i <br />Contf'acto�'s Ae9�t � Tenent (m�a� Dro�We a letterol coneantlrom lhe ownerro ao wnlKln I�e spao0) <br />State Llc. # <br />f( <br />ow�'� <br />1� � <br />�hone/E-mail <br />Phone/Emall 6%a� (U <br />CONTRACT PRICE OF WORK <br />T <br />Propoaed Use of Buildln /�` (� L I Gas_ �ectrlci��other <br />Building type: _ Single Famll Dup �x Townh Multi-Famify _ Commercial � <br />T e of ro�ect: New Addltlon Remodel e alr T,1. 51 n S rinkler Demolition • Chan e of Use <br />DESCRIPTION OF WORK (addltlonel speoe provld�d on the sack) : <br />����m �Ir �� C.�_ � �G Vl1Gl�� <br />� <br />SR�1N <br />PERMfT APPLICA <br />_..�aW �Addn _Al�eratlon �Rapafr <br />-- alr handllnQ uni� <br />ad air svstems <br />Other \ <br />R / SUPPRESSION SYS <br />Number of Meade <br />PLUMBiN6 PERMI`t' IkPpLICATION <br />Type of Projact: �f1ew�Addn �Ite�ativn�„Ropair <br />Show Numbor f� of fhr�urag <br />Tollet <br />Bathtub <br />KI[chpn Slflk & di9 <br />Dlshwashar <br />Clothes washor <br />Weter hea#er <br />S(nk (servlca/bar/i <br />Backflow pravent� <br />Ur{n�l • <br />Drinking Founlain <br />Floor draln "' <br />Grease�tra <br />Ftoof dralne <br />Medlcal Gas <br />Otf�er; <br />Qther: �^ <br />� <br />I heraby ceM�ry thal I heva resq and axamined lhls dppllcaiion anH know th� seme �n be I�UA and correct. All ppoVfslons aF lawg and oYd111e�ncea governing lftl6 ryp0 0( Wvrk wlll 6e COtTip <br />w11h w��lhor apeclfled hereM or not. Thg y�anlln9 of e permlt uoaa not presume �p glve aulhorlty lo vlolp�g Of cencel [ho proWg�Oh of any olher ote19 Or local I�yrregul�ting conaWoHon <br />Thet I am authorized by tne ownar oF lhie proD��ty ia perform tnp wOrk for wh�Ch q�pllCtitlon le mede anq I COmply wllh thB Stals Conlracrors Lsw 1g-27 RCW and 2D6.20Qn WAC. <br />/ �� Is1 <br />Own�rl uthoriz�d AgenC Slgnatur� � �� <br />D2f t� <br />(Rvvlsed 4l2045J <br />