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�1/2�/2�17 FRI 775$ FAX F��t WntOY HOAtCY �Q44/QQ4 <br /> .,. �Rnnr1" ap����,�►°�I�� I g I�"(�- ... <br /> � <br /> �UII�DINC/M�CM .A,NIC,AL/PL�IV�BINGISICN/SP#�1NK�ER/p�M�pL,IT�+�]►�1 <br /> CITY OF �VERETT PEI��1111T SECiVICES <br /> 3z00 Cedar St., Ever�tt, WA 98201 425�257-881Q �AX 425-257-6857 www.ever�ttwa.org <br /> SI'T�ADDRESS: A ` � � pR�p� Y x� ��� p��y1T� <br /> �v <br /> LCGAL fvr new AnstruCtlon: sno�t�latisubdiv�Bron Lot No. (at#ach copy of long leg�l deacrlpf�on) <br /> OWNER �s�'� � Phonel�-mall �--3 <br /> Address b � � <br /> b c►�v�sr�teiz�P �. , <br /> APPLICANT;,�bwn�r �„pW,�er.'s AtqenE �,Cantrpctor `Cpntrector's A ent <br /> 9 �Ten��t(muel provltta a lefter oi conaenl from lha orrner ta ao work m Iho pp�ce) <br /> coa�r�►c1�OR �,q- srate Lic.# 1/tll�l� g�Clf 8us.Lic. <br /> �PKvu 1 �"�� � � /� <br /> Addrass � �� '� � � t. �" � �,U' . � ` Phon�/Elttall a��3 I I.S �fi� � <br /> BUSI NA CONTAC�'FOR PERMIT �v-,� <br /> '�'� '�.�1�� <br /> PhonelE-mell L �,�4, <br /> �ly�I.DING �k�RIVIIY AP�'�,ICA'1"IllN CONTFiACT PRIG�OF WORFC �o� <br /> �xls�ing Use of Suliding 1-I�AT SO ��: <br /> F�roposed lJse of Bullding Gas Electrio Other <br /> 6t,ilding lype: �Single�amliy �,duplex�Townhau Muftl-Family Corr�mercial <br /> T e of ro ect; New Additfon �emod D�Re air T.I- St n S rinkfer Demolftlon . Chan e of Use <br /> [)�SCRIPTIQN OF WORK(addlt�onal speoe prov�ded on the becl�: <br /> , <br /> ��,�� r�',Q�t� �- � �C, �u?1��— <br /> , t���� <br /> M�CHLLM��AL �ERM�T APPL�I�A7�ON P4UMB�NG PEIaMIT APP�.ICATION <br /> Type of ProJect: Addn _^q�ter�tton_Rapolr <br /> 7'ypa o!ProJscE: ,"�NeW Addn _��taratldn_R�palr <br /> ShOw Number oP tlxtclrss Show Number of fJxturas <br /> A/C-- r handlln �nits - Tollet � <br /> Fvroed ir s tems Bethtub <br /> ��g � � Lavato weah basln <br /> Wat��he er Shower <br /> Gas flre I� Kltchen sink& is osa► <br /> Gas ran � <br /> Ciothes d ��shwasher <br /> Rwn e hpvd Clothes waeher <br /> �xhaust fan �Nater heater <br /> Heat um 5�nk servlce/bat/mo /etc. <br /> Unit he r gack�low reventer inslde bid <br /> Boife --- - -- Urinal � <br /> � � Drinkln Founfain <br /> R �ratlon �Ioor drafn <br /> oodatove Greaee��tr� <br /> 4uctln �toof dralns <br /> Other <br /> KLER !SUPPI�LCg$�p1W SYST�M Medlcal Gas <br /> Other. <br /> Number of Heads Other: <br /> I hereby paHlFy Yhet I hA1v�nAad$�d bxeminod lhle appROatlon end Know the a�me to be(fu0 end pp�YOot.All provlelona of 4��and ortllnancee poverninfl thla type of worK wlll be comp <br /> with whet�er apeCifl9d hereln or�ot,7'he yr�nfMe p�a permlt do09 not preaump Eo give aUthorlly;C ylolate or cancel ths ptpvl§loo q1 Any oiher Btlllv or bcal law regUlaUhg conatn,oUon <br /> That em HuthoNzotl bY th owngro!lhle - --- - •., .-_-- . <br /> property to pe�form liie yvaryc For whl��eppllcelfoh Is mqds and l comply wlth!he Sfale CcnVeatore L�w 19,27 RCW anu 256.200A 4Va,C. <br /> Own ! uth rlr�Ad Age Slghatqrq (���J ���( •-- �� <br /> Date ` ��vfsed 4/2096 <br /> 1 <br />