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06/O1/2p17 THU 16: 2� FAx Fast water Heater �pp2/V06 <br /> � �8'�D <br /> PERMI�APPLICATION <br /> BUILDENG /M�CHANIC�IL!pLU1VIBING!S�GPJ /SPRINKL�R/ D�N10LITION <br /> CITY OF CVCRETT PCRMIT SERVICCS <br /> 32D0 G�DAR STR��'f,L-'V�RETT,WA 98201 <br /> (P)42G-267-08�0 � FAX 423-257-88&7 �(E)evereltaps{gZ9vsral(W9,gov� ew✓w.evereitwa.�7ovlperml{a � <br /> Blue or�llack Ink On1 Plee9e) PliOJI���S�TE I�IFORM,AXNO1� <br /> AROJ�GT SITG ADDRE88: 7 T'ROPERTY TAX J�: �3 b � <br /> LEOAL for new conatructlan: snort PfaUsuudlvisfon Lot No. (altach copy oF long I�gel tlescrlpllon) <br /> CONTACT INFORMATION <br /> oWNER NAiNE: 7�NAN7'NAME(iP Commerclaf : <br /> OWN�R MAILINC ADDFt�SS: slae�r .� <br /> cm STq7E vr <br /> OWN�Ft pHON�: �� �� oWNER EMAIL: �—� <br /> CONTRACTOFt NAM�: '� S � `r <br /> CONTR,4CTOR ADDRE89: sTae�r � S ' <br /> CffY � � BTATE iJp ' <br /> CONTRACTOR PHONE: ��5 G(�NTRAC70�2�MAI�; ��1�'� ��S �"l� �i -�/}'. <br /> CONTf2AC70f2 LIC�NS��(R�QUIRED):� S"rw �' � CI7Y OF EVER�TT BUSINE33�ICENSe#(REquIRED) ��3 <br /> PRIMARY CONTACT: CI OWNER CON7RACTOR 0�THER(Pleaae Speclfy) <br /> GON7AG?'NA1VJ�: I CONTACT PHONE: �� <br /> K�'T� ��C I �/� CpNT�qCT EMAIL: �,�� � .�-�r, � <br /> SiJILaINq p�RMI'C'APPLIC4TION <br /> � Exist(n Use af Bul[din : - Contract Prlce oi Work:$ � <br /> prv osed Use of�ulld�n ; S Heat Sourco: Gss C7�lactrlc C1oth�r � <br /> Buffdln T a: SFi�-petsched ❑SFR�-Attached �Du lex OMUIfI�Famll -#of UnlEs: �ICommerclal �Industrlal <br /> T s of Pra ect: ❑N0W f�Addltlon ❑Relriodel Re alr �T.l, OSi n 09 finkler ❑DemoIIt1011 CICh�rl e oP Use <br /> D89CRIPTION 0�WORK: <br /> ��irn OU� � �2,�\�C� C� ��S �a�� `/1.�D�,-� , <br /> AssociATeQ BUi�.f�ING P�RMIT� IFa Ilcebfe: <br /> 11A�'CH4NlCAL P�RMIT APP6ICATION PLUMSIN�3 P�'RMIT APPLICATION <br /> lype of ProJacl: _Naw _ Addn _Alteratlon ___,Rapalr Typo of ProJect� �►Vew ^Addn _,Altoratlon _R�ps1r � <br /> #vf �lst of F/�urns #of Llst o!Flxtures �°f l.lat of F/xturas �°r Llst of F/xt os � <br /> Flxfures Plxturas F/xluros Ffsturea <br /> AIC�Alr Handltn Units Heat Pum Tailet Beokflow Preve r �nstde S1d <br /> � Forced Alr S stems Unit Heater Be ib Urinel <br /> Gae Pl In I3o�ler veto Wash Baslrl Drinkfn � talll I <br /> Water Heater f2erTf eratlon 5hower Floor i� n � <br /> Oas Flre lae� Wood Stove Kltch�n Slnk&Dle oeal Gre Tra � <br /> Gae Ran a Duetln Dlshwasher of bralns � <br /> Clalhea D et'Hooku e Ulhe�; Clothes Washer , Me Cal Gas � <br /> Re0 9 Wood Water Neater Olhe. � <br /> E�ch�ust Fan Slnk Servtce/Bar/Mo /etc Ot�er: � <br /> $p4iIN �R-/SIl RS$�O (1A � <br /> einlos!or W [�lc�.of Hoede � <br /> AC!(NOWLED(3EM�N7.'/hava revlewa0 fhla epplloe0on and conl�m the InPomiallon contelnetl hsre�ir Is��ue end cort�cf,Wotk done pu�sueRt!o!h/s permltmusf comply wltlf � <br /> cumerti laderal,a1ale.entlloca/!aw The granfMp of e permR enry eulRorlaes approvad work aad no tlavlQllons thorelrom.Devla[lon�a must Rrsf De aerinorhetl/n wrJfing ham tha � <br /> eulldlnq ofllola!be%re befng eulh�ed undereny clrcumstance.1 em fhe owner,orl am QuIAoA,seJ bY Ihe ow�ar of Ihls proparly 10 peAorm the worlc ferwh/ch eppllce(!on!s o�ade, <br /> end/c�omply wllh fhe S(afa Confreclors Laav 98.27RCW and 2ae,zaOA WAC. : <br /> c�ry ot Eve�tr oq�n�a�use onry <br /> � ( � ( � P�RMI�� .� �� �,.r � , �� � <br /> I <br /> own uthvrze Ag Slflnatura Data (Revse 4/23/20 6 ' <br />