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__ Oa/25/2017 TUE_10: 33__FAX_TFa�t water HOdtOY ____�_ 003/OOH <br /> • • -- �---�.r_._..—.. <br /> �������--•---•----•—••- -- �����.._....__._. . .._...-•�--. ..__._......--_•----- <br /> � ��� <br /> A�RMIT APP�.ICATlON <br /> .. Bur���No I nn�cHAt�Ic,�L I P�uMBIN�1 SIGN /SPRINKL.�R/�EMO�.ITION <br /> CI'IV OF CVER�TT P�RM17 SERVICES <br /> • 3�00 C�DAR 9TRk�7,EV�R�T7,WA 9s2o9 <br /> (P}42G-267�8810 � fAX 426-267-8867 �(C)evereftepa(�averallwa.eov J www.ev�gr�tlw�.gov/parmlts � <br /> Bluo or B[�ck tnl�Onl Ples�e) PEtOJE�T�ITe INFORMATION <br /> P�iOJ�CT 51TE ADDRESS: I� c��r pROPERTY TAX#: � <br /> , L�GAL lor naw construotkon: ShoK Pladsued{vislon ,�,J.ol Na,�__,,,,,, (altach copy oF Iong leeal deacdption) <br /> CONTI�►CT INPORMATION <br /> . oWN�R NAME: �" � T�NAiV7 NAME(tt Commercfal); �— <br /> OWNER MAIUNG ADDF��SS; eTne�r � � <br /> cm � e�rnre �/(� zn <br /> 4WN�R PNION�f OWNER EMAIL: .�'— <br /> CONTRqC70Fi MAM�t '� S '� "r <br /> CONTRACT�R ADDRESS: 6TRGET ` S <br /> cfrY �� � srn'2 Zlr� � <br /> C�NTRACTOR PMONE: �a 5 GONI'RAC70ii�MAII.� ��VI1�T J W �/Y�. <br /> COIVTRACi'OR L10EI�l6��j R�QUIRED)�� '�w N' G CITY O�EV�7T 6USINESS�.IC�NSE�i{REQUIR�D) <br /> PRiMARY CON1'ACl': Cj QWNE� CqN717ACT0J� L�OTH£R(Pl�a�a SpeoiFy) <br /> CONTACT NAME CONTACT PHQPfE: � <br /> K� ���� ` <br /> � coNracr ennAi�.: Wt j-1� �-wOl .�,Y, G��V! <br /> �LrlLD1N�P�ItMI'1"pPRLICA'1"ION <br /> _1,_ Exisfin Use of Bplldin : � Contract Prlce of Work:$ � <br /> � PYo osed Us�oi Bu11d1 : ^ Neet Source: �s �I�leCll'IC C�Olher .�- <br /> Bulldin e; FI2-Detached ❑SFR-Altachad �Du lex ❑Mulil-Famil it of Unita: OGommerclal ❑Industrla! <br /> T e of pro ect: �1New C]Addltion dRemodel Re afr �T.1. �Sl n ❑S rinkler ODemolltlon OChan o of tJse <br /> DESCRIPTION OF WOFtK; <br /> �vvl p�� l �2,���.C�. C��S w��� ��D��� ; <br /> A950CIA7eD�U(L.O�N�p�RMIT i� I!e IIC�bl9: <br /> M�CNANICAL P�RM1T APPLICATy0�1 PLUM�1t�O��+�IVIIT APPLICATION , <br /> Type of ProJeet� _Naw,,,r Addn �Iteratloe �epalr lype of ProJeef: __,_New ,_}Iddn �ltaratlan "�eReir ' <br /> �i af �Jsf oP Plx[�r�'es �of #D/ �of � <br /> Flxfur�s F�u�� L1af of Flxtures �xlU� s�o1F/xeure Flxturea Lfat F�lxturas � <br /> �1Ic–Alr Handtln units Heat Pum ou�t 6ackflow p venter Enslde Blde I <br /> � �orced Afr s terr�s un�t Heater Qathtub Urrnsl � <br /> Gas Pi �n �ollef Lawlta Wash Basln Dri Fountaln <br /> Water Weafer Refrl eratfon shower or Draln <br /> pps Fire leca Waod Stove Kltchen Slnk&D1s oeal G se Tra � <br /> Gee Rait 9 Ductln Dlshwasher Roo alns ; <br /> Clothea D er Hooku a Other. Clothes Washer Medlca ae � <br /> RAn e F(ood Weter Heeter OSher: � <br /> Exhaust Fan $Ink Seryice(S o �. Other� ! <br /> i <br /> SPR[N �S�IG M �. <br /> emioaf or W .af N�ade I <br /> AcwvowceDOEn9�N7:��have revlewea rnls eaa�allon and canram tna rn�a.malron con�alrre�l nereA�r�fruo a�►a ca•recf.worx done pursuant�o Inrs aermlt muar comply wlrn ' <br /> cuRe�rt/ade�al,sta1�,and loeaJ/aw.The grenllrtp of e permlf onry aulhorisea appmved work and no dev/aHons fhorefrom.Dmvlallons�nuet nrst Ae auf8orlaer!In wdtlnp�om fhs ' <br /> �U(Id1l1g OqklNl belbre bBing aufhWhed under eny clrcumsfenc�.I ariT fhe oWAeY',o�l 9rt1 Bu�hw/Red by tho aw/�er o/�h/8 p�op@�y fo perlorm rhe worh ferwh/ch ApplkgMort IB ATgtle, <br /> and I comply wiN1 lnv Slale Cantreclore Cew�a ai RCW end 298.200A wAC. ' <br /> c�ry o�E,re�rt oqiorer u�on�y � <br /> ��.�� I' PERM17�k� I `/ r ti � <br /> own uthorzo Ag Slgnatura Date �vrs�dsrearlois� i <br /> � <br /> i <br /> i <br /> i <br />