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48/ip/2p17 THU 11: 5a FAx Fa�t water Heater �jp�2/p07 <br /> — _ ..�.._�_._..�� _—-_.__T„-�. , �...,_.. _-..—__. <br /> � �� �� � <br /> � P�RMI'T'APPLICA�'[ON <br /> BUILDINO /M�CHANfC.A�. I PLUMBINC31 SIGN/SPRIN4CL�R/ D�MOL�fTfON <br /> CITY OF�V�RETT PERMIT S�RVIGES <br /> 3200 CEDAf�STREET,EVERETT,WA 98201 <br /> (P}423-257-gg�p � FAX�125-257-0�57 �(C)everettaps�everellwe.gov J www.evereilws.gav/permlts • <br /> 61ue or��e��k I�n�C�n� �leas� PRO.��CT$ITH IN�'OItMAT10N <br /> PROJEC7 SI7�AU[7RESS- j o�b �� pl�Op�fZ7Y TAX#: � J �� D � <br /> 1��GqL Por new construction: Short PI�UaubdEvlslon Lot No. (attaah copy of lonq Iegal daecdptfon) <br /> CON'rACT IN1F�/tlU1d171o1V <br /> OWNER NAME: TENAN'f NAME(IP Gammerclal): ��' <br /> OWNER M,A[LING ADDRESS: Srn�er � . <br /> cm V �'�' 9TAT� �t-1- z�� <br /> oWN�R PHON�: � 5 oWNER EMAII�: <br /> CONTRqC7�f�NAM�; '� S� '� "� <br /> CONTRACTOR ADDRE3S: sm�Er � S <br /> CfTY � � BTATE Z�P I <br /> CONTRACTOR PHQNE: ��� C GON7I�AC'fOR�MAII.; ��Va1 1T S �'LU �. <br /> CONTRACTOFt UC�NS�#(R�QUIRED):� S`rw r) � CITY 0��VERE7T 8U3INFr93�IC�NSE#(REQWRED)• ��3 <br /> PRIMARY CONTACT: ❑OWNGR CONtFiAC70{� ��ThI�fZ(Pieasa Speclfy) <br /> CONTAC7 NAME: CONTACT PHONE: � <br /> Kf"�� ��r1 �� CO�JTACT EIV1Al�: .Q�yV1�l-�"S -�PX'• GiS�I <br /> BUILDIAI� P�RIV���'A��LICA'�IbN <br /> � �xlstln Use oF Bulldin � Con[ract Prlca ef ork: � <br /> Pro osed Uso of Buildin : Heat Source: Oae DEleotrlc �lOther � <br /> Bul[dln T a: S�FR-Detached �SFE�Attached 17DU IeX 1�iUiult!-Famil -#of Units_ OGomm6Ycle) C11r1dU9tflal <br /> e of Pro ecf: ❑fYBw DAdditfon ❑Remodel Re alr b7.1. ❑SI n �S rinklar �Demolltlon ❑Ohan e Of Use <br /> DESCRIPTION OF WORK: <br /> ��lYl ��1�° � r�.�l�.C� C 1�'� �0��� �l �Gl,�� <br /> ASSOCIAT�D BUfl.DfNO PERMtT# If a licAbfe; <br /> MECHANIG!#�. P��tIVIN'�'�q,�Pk.ICA�'MON PLUMBINO P�RMAT.APP�IC4'1'IAN <br /> Type of Pra)eCt; �law � Addn �Itaratlon _Repalr lyp of Pro - Naw Addn �Itsratlon �,Repo�r <br /> *of Llsf o1 FI�fGY�s #�� Lfg(pf Flxtul'gg #or Llat of FIktGY ��f Llst of FlXt 6 ' <br /> Flxturas Flxturas Flxtures flxtures <br /> A/C—Alr Handlln Unfts Heat Pum 7aile Beck�low Prev�n nslde Bld <br /> � Forced Alr S tems Unlf Healer C3atht�b Urinal <br /> Gas Pi fn 8oller Lava Wash Basln Drinkln F laln � <br /> Water Haater RePrl eratlon Sho r oor D <br /> oga Flre loc� Waod Stov� Kltch n Sfnk&Dls osal G Tra � <br /> Gae Ran e DUCtIn Dlsh s er of n9 <br /> CloRhae D er I�ooku a Othet: Clotft Washar Nledlcal G i <br /> Ran e Hood Water eater other � <br /> �cheust�an Slnk S Icel�arlM4 /e#c, Other: � <br /> �PRIM � �$SIO -ST�WI � <br /> emlca!or w .oP Meads ' <br /> ACKNOINL�DGSML/V7'�Aava rovlewae(hls epp!lcallon antl contlrrn fhs Mfomra�lon confalned he»�n Is frue enC com�ot.Work done pursuant lo fhfs permll must comply wffh <br /> currenf laderel,sfe(m�end locsl!aw-The granfln8 0l a permlt only autlwrizas epproveu worh entl no devlaffvns fl�oreNom.Oev/at/ans muat nrst be aufnorkad m wilfmg lYom tlie <br /> eulld�ng Oftklel bel�?e Belnq au11wA2ad under anyW�cunrs(ance.f am�he pwner,or1�m aufhalzed by Ih�ownar oflhls propeRy lo per/vrm Ihe wo�k/a�wh/ch QppUc�llon/s made, <br /> 9rtd lComply wlfh fhe Sfefe Con�rectors LOW 1A27 RCW end 296.20pA WAC. <br /> C11y v!�Vereif OIyM,1el Uye Only <br /> � �� �� � PERM(�� /'� � <br /> � � � I d ����i � <br /> i' � <br /> owa r uthor zo A9 sre�ature Datm (Revlae 8/2 019 � <br />