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� �����. �l� `l�"-� � s� <br /> � � <br /> 'LEGAI.for new cor�strucUan: Shqrt PlaUsubdivision Lot IVo. {attach copy of fong iegai description) ' <br /> ` CCENTACT'lt+1PORMA7'!ON <br /> OYYNER NAME: �,�' �y� TENANT NAAifE(1#Commerciai): <br /> OYYNER MAILING ADDRESS: srn�r 3 r 3 �. 5'L� <br /> cm� L�V'G-c� " srnre .-✓ zm 2v3 <br /> OWNER PHONE: OWNER EMAIL: `jtj • {��i <br /> CONTRACTOR NAME: ,.r � $ L ti 6'� <br /> CONTt2ACTORADpRESS: snteer e �n' J <br /> GTY �� STAiE� 21P '�Z <br /> CONTRAGTOR PHONE: �(- dp CONTE2ACTOR EMAIL: �j��, � �,.?•!.�c"� <br /> CONTRACTOR LICENSE#(REt2U1RED):�/�lfE� J�/ L�T CITY OF EVEftE17 BUSINESS UCENISE#{REQUIRED):�"�j 3 3 <br /> PRIMARY CONTACT: p OWNER l�'CONTRACTOR �OTHER(Please Specify) <br /> C�NTACT NAME: CONTACT PHONE: 3� �O���71Ch� <br /> ��h �JI�G`�-- CONTACT EMAIL: Kp�J�n./��l� ``�rrt�.l•GOt�-i <br /> BUILDING PERMIT APPLICATION ' <br /> Existing Use o#Building: Contract Price of Work:$ OS <br /> Proposed Use of Buildin : Heat Saurce: �Gas C1Eiectric �Other <br /> Buitdin Type: �SFR-Detached ❑SFR Attached ❑Duptex OMulti-Famity�of Units: �Gommerdai ❑Industrial <br /> T of Project:,l�New ClAddi�on ❑Remodel �R ir �T.k �S' n OS dnkier I7Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK�^ � . � .}- <br /> .�tS�G,� �S lels�-{ i.�7�7d� �a,5 �+v;'� <br /> ASSOCIATED BUI�DING PERMIT# if a licable: <br /> MECHANICAL PERMIT APPLICATION PWMBING PERMIT APPLICATIQN <br /> Type of Project_New_ Addn �Aiteration_Repair Type of Project _New _Addn Alteratfon Repais <br /> Flxtures List of Fixtures Fbctures lJst of Ftxture�s f7xtures List of Fixtures Ffxfures List of Fxtures <br /> A/C-Air Handling Units Heat Pump Tailet Backftow Preventer{Inside Bldg) <br /> Forczd Air Sys#ems Unit Heater Bathtub Urinal <br /> Gas Pipin Boiler Lavato (Wash Basin} Drinkin Fountain <br /> Water Heater Refigeration Shower �loor Drain <br /> Gas Freplace Wood Stove Kitchen Sink&Disposai Grease Trap <br /> Gas Range Ductin Dishwasher Roof Drains <br /> Cfothes D er Hooku Other. Ciothes Washer Medicai Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(ServicelBar/Mopletc.) Other: <br /> SPItINKLER/SUPPRE$SION SYSTEM <br /> Chemical or Water Na.of Heads <br /> ACKNOWL.EDGEMENT:1 have reviewed this appRcafion and confirm the tnfomraSon contafned herein fs tn�e and correct Wo�lc done pursuant to this permit nn�st camply wifh <br /> currertt federal,stafe,and locat 1aw.iha grantirrg of a pemrit onty�uthorizes approveri wo�ic and no deviafions fharefrom.Reviaflas must Srst be authorized in writTng fromlhe <br /> 8uJldi»g Otficial6efore being authorized uaderarry ctircumstance.l am the orovner,orl am authorized bythe ownerofthfs properly ta perform the work forwhFch appGcakon Fs made, <br /> and f compty wifh the State Contracfors Law i827 RCW and 238.200A WRC. <br /> City of Evereft Official Use OMy <br /> PERMIT# <br /> ,�-�---t��I�'�-- �/� Jr� m, �.�o?��b 1� �� <br /> OwneNAuthonzed l�yent S�gnature Date (Revised 9/23/2016) <br />