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Nov, 21. 2')16 2;42PM EVr REEN STATE HEAT & AC�,q�p���,q��o��, No, 8374 F', ' <br />�IJILDl1�� M�CHANI�AL / PLUM�ING I SIG�tll��II�KL�R / D�fV[0�.7 i IOPV <br />CITY OF EV�RETT PEFtiUIIT S�RVICES <br />��`�' 920o cEOAt� s'1`R�L�r, EVEREI�', VUA 96201 <br />(Pj 425-�57-86'[0 1�AX425 2b7-6B57 j(�) everet(eps�everef(wa.gov j www.ev��-et[wa.gov/parmi[s <br />___. . . . _. . .. _.� .... _ . . _ _ . -. <br />- --�- • -•-.---•.. <br />� ����' �1�� � �ta � -��' i�aea�e � :� . _ �Lg,��.. �'d`,.91� HA���R � � ' - . _ , .. _ - <br />.. �.. ..,- .-- --��- -•�--�-� - .�_. AA_.� :- . .��.' -� . , . <br />C�ROJ�CT SIT� Al]AR�SS. `� /�-1L/,vl� �il 1'Tc> � PROI'�k2"i'Y i'AX #: <br />LEGAL for new coaslrucdon_ Sha�# Flatlsubdiviainn �of Nn. (alta� cop� af fong legaf descrtptlan) <br />P <br />_ �� = <br />e of <br />� �_� . �- � � � � " ' �:.BI��LbYt�t('.�,,.I�IRIYII'i':AP�I:ICA'T�OI <br />Use of Bullding: Contract Price o� o� <br />j Use oFBullQing: HeatSource: ❑Gas <br />e_ C1SFR-Detachect dSFEt A�fached I�puplex ]ti-Fami[y-# of Unffs: <br />'�ofect: C1Afew �7Addition 17Rernodel ❑Repair CIT.I. I�Sien C7Sprinklel <br />�rrou oF wo��c; C�U��S[� O�-� �E-S (��4cr� <br />�UILbINC PERiNIT# (if <br />e.�,.�.�t�� �_ . . �. _ � � -. . <br />❑Commercial ❑lndustriaf <br />C(Demolftlon 1�Chanc�e of Us� <br />ACKNOWLEDG�MENT I have reNev�ed ihls applicef,on end conflrm �he /ntormslion containedhersi�;s fnre end wn�ct. Work done pursusnf to ihls permlt must raomply wiYh <br />currenffedersl, sfate, sndlocal Isw. Tha pranUn� ofa permlf only autharizes epproved work and no devlstlons (herefrom. Devlaflons must ffrsf be authonzed in wG(Ing from fhe <br />Bu11ding Olfiolalbefort3 being aulho6zed under any circumsfenca !�m the owner, or/ am authorizedby the oviRerof fhia prapedy to pe�onn iho vi�rk fo� v✓hlch applicetion 1s made, <br />and I comp�tivith lhe Sfate Contr�ctors L�w 1 B.v RC1Nand 296,240A WA� <br />'� `-i'�� � �"� " V � I '" <br />Agent Stgnature Date <br />Clly of El�erett Otflcla/ use onry <br />� p�l , � l <br />r �SQ <br />(ReviBed 5,l'10%10'!6J - <br />