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11/21/2�17 TvE il: da FAx Fa�t water Heater f�007/008 <br /> . g��a � s <br /> P��nn�T�eP���c�a��a�v <br /> BIiiLDli�lG/M�CHANICAL /PI,UIllIB[NC3 !SIGRI 1 SI'FdINPrCLEFl 1 D�11N0�.17'ION <br /> CITY OF�V�RETT PERM17 SERVICL.S <br /> 3200 CFDAf�STREET, �vER�-rT,WA 9a2U9 � <br /> (P)425-257-Be90 � �AX 426-267-Oa57 �(E)everettaps�everetlw�-Sov� www.everettwa.gov/permita <br /> l�Cl�a� �p�31a��C Ink Onl ��0��� P�£�.D��4'S17'� 1NF092M!#q`M�f�Y ;r: <br /> PROJECT SITE ADDR�55: PFlOPBRTY TAX#: � I '� <br /> �.�GA[-For naw canaEruotion: Short PlaUsubdlvlalon Lot No. _ (altech copy of long legal desariptlor�) r <br /> co�rr�,cx��vFo�a►nnrr��v <br /> OWN�R NAiVIE: � 7�NAN7'NAME ]f Cot�morclal): � <br /> OVVN�R M,AII.ING Ap�RE59: srneEr �b <br /> CfTY 6TATE 31P <br /> OWNER pHONE: OWNER EMAIl.: <br /> CONTRACTOR PlAME: ST 1� T� <br /> CONTRACTOR ADDR�SS: s7REEY I S �� <br /> CrYY � � T 9YATE Ylh 1 <br /> CONTRACTOR PHONE: ��S CONTRACTOR EMA1L: ��U}'�1 IT S �l.�J �. <br /> COAITRACl'OF�UG�i�1S��I(R�QUIREo): S �} �� . QITv oF ev�Re�re eus�Ness Lte�NS�li{R�WU�R�o} ��3 <br /> PF�lNIARY CONTACT: C�OWN�R CON7RACTOR �OTHER(Pleaae SpeC{Fy) _ <br /> CONTACT NAME: CONTACT pHON�: �� <br /> l�l�� ���C"I �� CONTACT EMAIL: {�/�kM�I�S IA�Q�, `�vi' � vu V�I <br /> BUII..�II�+I(d P�R{v�MT Ap�LiGA7'Iarl <br /> � Exlstin Uee of Bulldln : "' Contract Prlcs of Work;$ � <br /> Pro osed U8e of�ullding: I-leat Source.- �e �Eleotrlc ClOther � <br /> Bulfdin T e: SFR-Detacl�ad �SFR-Attached ❑Du lex �7Multl-�amll �#of Units� �Commerclal ❑fndusfrial � <br /> a pf Pro eot_ ONew ❑AddlYlon ClRemodei Re alr OT.I. CI51 n ❑5 rinkler ❑Demolftlon ❑Chan e of Use <br /> b�$CRIPTfON OF WOI�K: <br /> �vV� D��� l ��,�\�.�� � n � S ���� � � G�;��I' <br /> /`� <br /> As50CIATLD 6UI�pfNQ P�RMIT# IF a licable: <br /> Mk�CHANI�AZ P�RMy'T A�pk.MCAXyON PLUM611�(� P�RI{fIN7 APpl�RCI�TION <br /> 'Typa of Projaat: ^„JV�w _ Addn _�Ukaratlon �apalr Typa of Project: _New �,ddn _�Iteratlon �Re Air <br /> Flxturas �/sf oPF/xture9 F���� Llat of Flxtur�s Frxi��3 a�Flxtures �uYeB Llst of xtures <br /> A/C—Alr Flandun Un[ts H�ak Pum Ilet BackPiow Pr ont�r Inslde 81d <br /> � �orcad Alr B stems Unit Heater Bathtub Urinal <br /> ` Gae Pl fn AoAer Lavato W�eh gasln rinkin �ountain <br /> Wator Heater Refri eratlon Shower FI ra[n <br /> c�s Flce face Wood Stova Kltchen s�nk&�Is osal o e Tr� <br /> Gae F�an e Ductln qlgnWas er oof alns <br /> Clathae D er h{paku a Other: Clothes Washer Medlc�l s <br /> R�n e Mood Water Heebat Ofhef: <br /> L'�ch�ust Fan Slnk Servlce/Bar/Mo /e Othe�: <br /> SP�i�{d ��510 M <br /> emlCal or W ,af Heade <br /> RCKNOWLEOG�IN9�NT.�I havA rgvlewud tHls eppllaallon entl canllrm the InPormellon coRtelned her�ln Is�ruo and cwr�cL Work uone pursuWnP�o Ih/s permlt must compty w/rn <br /> ccrrrenf lederel,stale,end loca�raw. Tha granOng ol e permlt arrly auti�a/zes�pproved wak end no devlaUona�horetYom.Devlatlons muet Ilrst se aufAorneA ln wrtfing hom the <br /> 6u!ld4�g OflYcla!beh�re being eufhorl2ed under eny alrcu��sfanca.1 em the awnmr,or/em eu�harlcetl Oy Nre owoar ol fhla property lo pe�/orm the wark for which eppllceNon Is maQe, <br /> ond 1 QomplyWl�A Ih�9(sfe Confreciors Low 9B_27 FICW snd2D8.200A WAG. <br /> C�ry oP Evargtt Orylcle/Use Only <br /> —� I — ' � PERMIT# I.� a /� <br /> ' U `V <br /> own r uthar za Ag s[gnatw-e Dete Revlse 320 6 <br />