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�2/�6/2�1$ TUE 13: fl3 FAX F��t water HCdtOr �QQ2/��� <br /> �a�a� � <br /> h�t�lilllT APP�1C�►�'IOIV <br /> BUILpIPd�/tUIECHAIri1C,4L!PLUM�iNC�! SI�N/SPRIN�LER/D�MO�.!"I'IOM <br /> GtTY OF EV�RETT P�RM1T$ERVEC�S <br /> 3200 Q�OAR STR��T,�vERETT,WA 98201 , <br /> (P)�{28-267-8890 � FAX 426-Z&7-8067 �(E)everetteps�everetiwa.�ov� vrwuv.eVetetiwa.goV/perrl�ft8 • <br /> �s,���x���o� �n�c o,�i �le�rise) �G'€0.8EC'P�ITE aN�06tMaL9'IONf <br /> PRD.I�CT St7C Ap17R�S5: � pI�OP�i2'tY 7AX#: � �� b � <br /> L�GAt�Por nrsur canstruatlon: short P�at�aued�vlslon Lot No. (attech copy o41an8 legal d�soriptlan) <br /> ' C�I+IT,R#CY IN�01R�IlI1TNON <br /> OWNER NrAME: � � �C TENqN7[vAM�pP Commerclat; <br /> O'WNL'R MAILfNG ADDRESS; g��� <br /> CRY STATFi/r ZIP <br /> OWNER PNON�; OWN�R�NlAik.: -'�� <br /> coNTRacro���,Me: � 5T �, �- <br /> CONTRACTOR ADARESS; srReEr � � S ' <br /> CfTY � � ^ SCAT� YIP �, <br /> CON7IZAGT012 PF10[YE: �a S b CONTRP,CTOR EMAIL: R.U� IT S �'LU -�, <br /> GONTRACT�R LIC�NS�#R�QUIR�D): S� � �j� CITY pF EV�RETT H1J��NEB$L,iCENs�i!(R�QUIRLD)• `��3 <br /> PRIMARY CONTACT: ❑ OWI�f�R CONTRACTOI� C7 07H�R(PI6�86 SpeCffy) <br /> GQNTAGT N,q11N�; �/ � C4N7'ACT PhlON�: ��'�' <br /> t�-►�� '��i'�L� coNracT�nna�L: Vt/l-I-i� -4�X� GblNl <br /> �titILD�Nfo P�lZtVli'�'QP�LIi."A'�'�dl1� <br /> � Exlslln Use oF Bulldln ; Contract Prlca aF Work• � <br /> pro osvd Use af Bulldi : Heat So�trce; as ��lectric �Ofher � <br /> Bulldin T a: 05FR-a�tached �SFR-Attached �Duplax C7Mqlfi-Famil -#o#Units: omm�rclal Dindustrl�l <br /> �p o'f F'ro�ct_ I�Ptew L7AddIt(on laFter'rtadel Re air CI7,l, C7Sf n CiS rinkter C1Demolltlan ❑Chan �oA ilsa <br /> p�SCRIPTtON OF WO�tK: <br /> ��M p�� � Y��,Q�o�.�� C�'S w��� �/1 �GL,�� <br /> ASSOCfATED�UfLDINO PERMIT# iF e lioable: � , Q 1' I <br /> lVIkCHAI��C,AL p�RlV�1T A�p1,1CAXIVN PLtYlY1�f11�6 pL1iNJp'�'A �MCJi1'!'ION <br /> 7yp�oP ProJact: _IV�w_ Addn _p,ttaratlon ,_,,,I�apalr rypa of Pro)act �N�w „_,_Addn <br /> _�1loaratlon �iapalr <br /> #oP Llaf o�Fhrturas �°� Llse o!Flx[ures �°f Llst of�lxterea #°t Lfsc t�lxturgs <br /> Flxtures Flxtr�res Fhceuras �lxturas <br /> A/C—Alr Handlln Untts Heal Pum 7otlet Sacldtow revent�r lnslde BId <br /> ;,. Forced Alr S st�ms UnfE f-leater [�athtu urine <br /> � GaS Pf fn Boiler La Wash H� D !n Fount�iln <br /> Water HeaEer R�ir� �ratton Sh et Ioor Drein <br /> Gas Flre leca Waod stove Klt hen 51nk&Dle�osal arease'�ra <br /> Oae i�an � bucNn DI hwasher Roof Dralns <br /> Clolhea D er Haoku s dther: Cf h�s Washer Qdlaai G�s <br /> Rfln �Hoad Wa Of <br /> �xhaust Fan Sink 5etvice/B�r/Mo etc, diher: <br /> SP�t�N F$SSI4 1fST�M <br /> �mlcal or W .af hteade <br /> ACKNOW�L�I�GEMl�N7'I AAVe rAWewed fhls epp/(Callon end canllrm fhe bJfwmeflon aontelnad har�ln!s trY1e 9nCCOI/eCE WoYk tlone puYsuent!o Mfs pe»trlf mu8f GOmply wltf! <br /> cu��rn�letlarel,afet�end loca�taw.7he Arer►llna of e permk only eufPtorlses epA�vved wodc and no dav/el/ons thorBfPam.Dav/af/on8 mvst nrst be aWhwf�ed/n wr/Hng lrom the <br /> BUNding ofNclel ba�mt�De/ng aufhoBaetl undar eny cl�umatance.!em fhs ownsr,orl sm sull�oAxed by tha owner of Mla Ai�opeHy(o pertorm�na worh for wHfcA app71ca1/on ts mad�e, <br /> and/comp/y wltlt lhe Sfate Con�rectora Lew d8�Z7 RCW�nd Zee.,200A 4VAC <br /> /�` � � Gty o��verelt ona���use aary <br /> � P�� O <br /> Own uthorze Ag hf8ignature Dete (Revlse O <br /> �_�..�._............—�.......__.r, ' I <br /> �w <br />