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1p/3p/2017 MON 15: 02 FAX Faat WatOr HOatOr 1�002/008 <br /> II���� <br /> �EP2M!'f',APP�.IC,�#�14� <br /> Bi.P1LDINC/M�CHANICAL/PLUMBIh{G/ �iGN!S�'i�IRI1K�.E�L I�DENIOLITIpM <br /> c�-r�o�Ev�R�rT PeRn�rr s��vic�s <br /> � 3200 G�DAR STREtT,Ev�R�'n',WA gszoi <br /> {P)425-2�7�8B90 � FAK 425�287�8867 �(C)everelteps�everellwa.gov� www.everetlwa.gov/permlts • <br /> �lue or�l�ak Ink�nl ��a�s� �it�.A��l('SiTE IIdFOIZM�f,4'IOtW <br /> I�ROJ�Ci'Sl7�AADR�SS: � PROP�RTY TAX�: ''V � <br /> L�GAI�Por now conatruotlon: Sttort P�aUsubdlvislon Lot IVo�_ (atkach capy af Iono laea!deecrlptlon) <br /> CONTA�T INFO#�dif14T10W <br /> OWNER NAME: TENANT NAM�(If Comrnerclsl): <br /> OWN�R MAfLIN�ADDRE59: S7RE6T <br /> Cm' U s7A� v� � <br /> aWN�R p►�or��: OWN�R EMAIL:,/^' <br /> COMTRACTOR NAM�; '� S� � `� <br /> CON7RACTOR ADDRESS: srREEr � s <br /> , � Cfi`( � � � STAT� YIP 1 <br /> CONTRACTOR PHO�l�: ��5 CONTRACTOR EMAII.: Q Vrl IT S IJJ �. <br /> CON�TRACTOCt LIC�PISE�(fiEG1UIRED): �� U� �� C�Ty pF EV�RETf Bl1$�NE83 LiCENB�#(REQUtREDJ ��� <br /> PR[MARY CONTACTa ❑OWNER CONTFiP,CTOR ❑dTH�R(PleaBe 5p6CIFy} <br /> GONTACT NAME: CON7'AC7 pNON�: �� <br /> Kf'"�"� 1`�T�/� CaNTACT EMAIL: �,�� C�-�� .�-�. ('j(�� <br /> �U9LD�t�O P�RtVIy'�'APPLI�ATlON <br /> �f �xlstln Use oP Bulidln : " Contr�ct Prlca of Wark:$ � �' <br /> '� �Pro osed Use of Bulldi : Heat SourC9: Oas ❑EleotriC C.��thar <br /> B�Ildln e: FR-D�t�checl �SFR Att�eh�d ODu le�c G1Mu1H-Famll �of UnIEs: OCvmmerclal ❑Induatrl�I <br /> e Of Pr0�Ck: C1Nsw L7'AddlNan CIR�mod�l Re alr CIT.1.' �Sf n �S r►nkler �Q�molltlon L7Chan e af Use <br /> b�SCRIPTION 0�WORK; � �� `� <br /> �Wl 0�� �Q G� ��t�"S w a�-�� ��a,-�� <br /> ASSOGIATED BUILE11N0 P�RfUII'T# If a IIcBple: <br /> llf�kCHANICAL p�RM1T APALICII'�'�ON PLUMBING P�RM1T APPLIC,1�1T10N <br /> �ypa ot ProJeat: .,�Iew,�., Addn �Itarativn _,Rvpaf� Type of Proje�t: _New _fqddn iteratian <br /> �1 ..�2apnir <br /> Klxturas �s[of Flxeures �u� Llat�Plxtures Flxturea �lat uf Flxturee Fl�u� Llat of�'lxt�res � <br /> ArC�Air�andun Unlfs Heet PUtn Tailet eackflow Preventer I Icle Sld � <br /> ;,. Fol'c�d Air S tems Untt Heator BathtUb UrfnRl <br /> ` a�s PI in �oller Lava6o Wash dasln �Drinkin Fountsl � <br /> Weter Heater RePr1 eratfon 3hower ar Draln ; <br /> Oae Flr� f�ce Wood Skove K(tchen lnlc&Dls osal �re T � <br /> Gee Ren e DUc�in E71�hWae r Roof e <br /> GlatheA D ar Haoku a oth�r: Ctothes aher M aal Ga � <br /> R�n 9 Hood Wster H�� fher. � <br /> CXhauet Fal1 Sink Service/ o etc. Ofher: � <br /> SPRIN PS$i�Q M � <br /> emlcal or .of Heade ' <br /> aC�WOVVLF��M�Ni`l heve revlewed fhla eppNcaflan end conf/m,the/nPam,e[1an confalned hara�n!s true satl convct Worlc donm p�rsuant to thls permlt�nu�t�mp1y wlth <br /> currenf feder�ef,atslo,end lecal lew.THe grenNng of e permlt a�fy eu[halaes epproved wark and no devlal/ons lhereflnnr.DaNatlona m+rat Ors1 fie euUrorized!n wrlting lrom fJ�e <br /> Bpllding O!'l1Cld!boPaie befng eulhvrhed under eny C/fCums�ance.I em fl�e own�r,or 1 am su[hor/sed by the ownar of fhJs p�operly�o partorm 1he woilr lorwhlch Qppll�f�on!s mede, <br /> arttl/Comp(y wllA 1bo Sfate tibnlrxtctois LOW 7B.2T RCW and 29d2d0A WAC_ <br /> G(v ol�vereft OMc/a!!!se On�y <br /> �� , �O � I PERMyi'1i► � � p� _ yc �� � <br /> r v i c� c� <br /> Own utnor Ae Sigrsature oate (R9VI66d 3�zo9e ' <br /> .^_._._�._. -.-__...�'......._-..___.....-_ ____�� <br />