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08/10/2017 THU 11: 58 FAx Fast water seater f�p0a/007 <br /> _'"�= — ,_-�..._».._.,.r._.._.,,,_.._.�__�,:._._�..._��_ <br /> I <br /> � � �3� <br /> � PERI41iiT APPLIC�TION <br /> BUILDtNa!N{�ChlANICAL I��.UMBING 1 SI�N/S�RIN4CL�R 1 DEMOLlTIOIV <br /> CI7Y OF EVCRETT PEFtMIT SERVICES <br /> 320U C�DAft S'i'F���'f,�VERETT,WA 98201 <br /> (P)42�-257-8610 � FAX 425-257-8957 �(�)averettOpsQevereRiwe.pov� �wrw.e�ereltwa.gov/permlts • <br /> Blue ar�Na��I�nk OnL Plesse PiE�O.�R��'SN7�l[�FQ�MA'�'NOI� <br /> PRO.I�CT SIT�Al]�RES3: V PROPERTY TAX#: � <br /> t,�GAt Por new wnetraction: Short PIaV�ubd{vlslon�, kot No, (attach copy af IanB lagal dgaeNptlon) <br /> CONT,�#CT INFORNIATlON <br /> OWN�R NAM�: � T�NANT NAME(U Co�marcla�;r"' <br /> OWNER MAIlING ADDRESS: 81tiEer <br /> orn ernTe ztr <br /> OWIyER PHON�: � OWN�R�MAII.: --�—' <br /> coNr�qcraR NAf��� '� S <br /> CDiVTRACTOR ADDRESB: srReer � S <br /> CfiY � � � 87'A'f� ' YIP ' <br /> CO�lTRACTOR PHON�: �a� CONTRAC7`OR EMAIL: �P.,II� IT S '�'U� "�, <br /> CON�'I�ACTOft LIC�NSL'#(REQc11RED):� S'� � �j� GI'fY OF EV�R�TT BUBiNE65 WCENS�sY(REAUIRED) l,!`��3 <br /> PRIMARY CONTACT: ❑OWNER CONTRACI'OR L7 QTF��R(Pl�aee Sp9CIFy} <br /> GONTACT NANl�: CONTAG71'HONE; ��� <br /> ��-� ����� CONTACT EMAIL: 1rVI�I"rS J(�. 'T�► � C�$lNI <br /> BUILOING P�RMIT APPLICATI+QN <br /> � F�c(sttn Us�of Bulldin : • � Cor+tract PPioa Of Work:$ � <br /> Pro osed Use oF Bulldin : � HeAt Source- ag C�Electric �Other � <br /> Bulldln T e: FR�Detsched OSFR�4Ltached ODU lex 17Muf#I�Famll -�of Unite' C1Cor11m�relal �lndustdai <br /> e of Pro ect ONew �Addlt(an ORernodel Re air I�T.I. C151 n Cl5 rinkler [1pe17'lolltlon ClChenge oP Usa <br /> D�SCRIPT[ON OF WOR}C: <br /> �VY10v� � Y2,��D��� ��}"`S tn�D�-�`-� � �°Gl,��l�' . <br /> ASSOCIAT�D BUILDINO PERMIT� iF s ilcabfe: <br /> MOCHANIC,1#M.��RMM`f'A�P�.IC,A�T�ON PLUMBIt�6 P!lRMDT APPLfCATIDN <br /> Type of Prol�ct: „_,Naw� Addn �4ltarallon �Apelr Typo of ProJs�f: ,_,,,Naw ,_„Addn _Atteretlon �epslr <br /> �!vf �rs£oP P/xturaa+ #p9 l.Ist of F1xlurea �°f s1 of PlMvras #°f Glst of 1�lrtur <br /> FYxturas Flxtares Rxtures u�a � <br /> l�/C–Alr Wandlln Ui�Its Heat Pum ilet eackflow Preven Inslde Bld I <br /> � Forced Af�S stems Unit Mealar athtub rina! ! <br /> Gas PI fn .�oller I.avata Wash B�s�n kin Fo In ! <br /> Water Heatar Refrl eradon Shower F[o Dra <br /> c3aa Flre lace Wood Slove Kitchen Sink&Dle osal Greas ra � <br /> Gae Ren e Ductin I}lehwasher Ro r s � <br /> C(othes D er Hooku s Other: Cloth�s Waeher. edicai� j <br /> Ran e Hood Wat�r H�ater Other: < <br /> �chaust Fan k s�ru�ce/Her/Mo /eto. Other: � <br /> SP�tIN �3510 � <br /> emlcal or W ,oP Heads ' <br /> ACKNVWL�OGEM�.'NT.'/hava rovlawad riva appllcallon an�eon�im tne Inlarmatfon eontaMed hereh+�s rrtre erad co.recf.W�danB peusuenf ra rh�s pem,�t must eomply wltn � <br /> currenf federe(afaldi enat laca)lew,The Areqfln8 al e permlf onJy auiharizes approved worlr antl na dsWoUone(Rare/lam.Dewef/ons musf f/rsf Aa aufhodxed fi w.rNeg hvm the <br /> Bultding ORk/el baPore B�Ing nulAon3ed urnfe�any droumslanco.I am fha owner,or l sm aufha+�zed by the owner aF fhla properly fo pa�famf!Ao wo,�K for wAloh epp!!ce!(an!s maafey <br /> ertd/aomply wJfh fh9 SfRre Gonlreclvr9 Lew i8.27 RCW and 28B.200A WAG <br /> cxy ofE�r�tt o►�vuei usa vnry � <br /> ✓ � V � P�aNI �-/ �^� <br /> lJ U <br /> Own uEher zo Ae 9�gnature Date ( ev se 1) � <br /> , <br />