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48/23/2017 wEo la: a0 FAx Fa�t water xeater 1�005/008 <br /> PERI1lIl�A�'P�.ICqTION ` D����� <br /> B�JILDING !M�CHANICAL I P�LUIIlIL11VG /S[GN /SI�RII�K�.�R/ DEMOI�iTION <br /> CITY OF CVERET'I'PCRMi7 SCRVICCS <br /> 32U0 CCOAR Sl'f2L�'f,�V�RET7,WA 98201 <br /> (P)q23-257.8010 � FAX 425-257-SB57 �(E)everelteps(c�ev�rellwa.gav� www.evaretlwe.gov/perm(ts � <br /> gluo or 6��ck I�k�n1 Pl��se F�iOJI�C�'S17� iPM�r�IliM�ITMOIW <br /> PROJECT 3ITE ADDRES3: � PROPERTY TAX#: � <br /> LEGAL fvr new wnatruotton: 8hort PIAF/aubdlvl9lvn �ot No,� (attaah copy aF Iong legai dasarrptton} <br /> CONTACT INPORMATIUN <br /> �wNFR NAM�: � TCNAN7 NAM�(If Commercl�l): <br /> OWNER MAlLING A�DR[-88: ar,��Er <br /> cmr arn� w �Ir <br /> OWNER PHON�: OWNER EMAIL: ��"� <br /> CONTRACTOR NAM�� � S I <br /> CON7C�{ACTOR ADDRESB: sraeer j � �� <br /> crrr � � + erA� - nr 1 <br /> CONTRACTOR PHOAlE: �'��� CONTRAGTOR EMAIL: �.UV� 1�T S �I.0 �P/}�, <br /> CONTRACi'oR LlGIENS�#(R�auIRED): �fi �'f gj� C17Y OF EVERETT'BU91[�lE88 LICENgB#(REQUIRL-D) ��3 <br /> PRIMARY CONTACT: ❑OWN�R CONTF7AC70R ❑OTH�Fi(Pleaee SpBCIf}/)_ <br /> cON7AC�'NAM�: cONTAC7 pHOt�E: 1...��� <br /> Kf'�'� '`��V�� CONTACT EMAIL: ���-�-5 � ,�.�� �� <br /> BUILDiNG P�RMIT APPLICATiON <br /> � Exlsttn Use of Bulldin : Contract Prlce of Work:$ '� <br /> l�ro oaed Uae of Buildin : Heat Source; Gas L7Eleclrlc C]Olher � <br /> Bulldln T e: SFR�Detached �SFR-Attacheci ODu I�C ❑Multl-�amfl -fp of Unita; QCommarcial 1�(Ildustrig( <br /> e of Pra ect: ❑New DAddifion ❑Remadel Re air 17T.1. OSl n ❑5 Yfnkle� ❑Demolltlon ❑Ch�n �of Us� <br /> D�3CRIPTION OF WORK: <br /> �V�n OU t° � �2,�10�.�� C�-� �0`-��Y � �D�,��'" <br /> ASSOCIAT�D BUfLDfNO PERfVI1T 1F If a licable: <br /> M�CHAN�C/#r. P�Mi1V��'x'/#PP�lCAXRON PL��VI�IN6 �LRiV1QY APPLICNTION <br /> Typa oP PfoJAeti _.f18W Addtt _/1ltaratlon _�tops}r e af Pra act: w <br /> Typ J ��1ddn �Altaratlon _Repal <br /> }�of Llst of�lxtures #°� l.lst vf F!x{ures �°� Lfs�a �Dcture� �°f L/st of F urae <br /> Flxtures Fhcturas Flxturee F/xtures I <br /> A/C�Alr H�ndlln Unfts Heat Pum Taii�t 8ackffaw P� nt�l' Inalde Bld <br /> � �ofced A!r S stems Unit Fl�ater Bathurb UClnpl <br /> pas PI in goller I_avato Wash Basin Drin Fountal� I <br /> WaEer Weatsr Refrl eretfon Shower F r Draln ; <br /> Ofae Flre fece Wood Skove Kltche Sln[c 8�bls osal resae 7r� <br /> Gae Ran a Ductln Dfehw sher oof pralne � <br /> Clalhes o er Hooktt e �ther, C1oti�e Waeher . dlcal Gas i <br /> Ren �WOod Water eQGar Of r: � <br /> �Xhaust Fan Blnk erVice/BaUMo C. Qthe . � <br /> $pglN $�Io IV1 � <br /> emlcal or W .of Meads ! <br /> ACKNOWLEpG�M�N7'I heve��vlewatl thls app�IcaOon and con!!rm fhe Inlormeflon con(�lnetl heraN�fs Ircra arid correcl.Wo►k dona puisuant lo fhls perrr�lt muat comply wlfh <br /> cun�nf fetleral,sfafe�end lacel!aw The grenNnA v!a permlt only aulho�fres eppraved wprk and no devlallons fAereJtvm.O�vlatlons muet/lrsf Ae aufna2etl M wrlOnp lrom the <br /> Bu!(ding 011�1e1 bafore Oaing aufAorlsed under eny dicumsfor�cs.1 am Ihe vwner,ar I ani aurho�lzed 6y fhe owner allhls prope�y�o pe�farm lhe worJr forwhlch epp!lcallon ls metle, <br /> 9nd/ComAly w!(h(he$lete C,bntrec(or9 Lew 18.27 RCW and 2Ad200A WAG <br /> Clly of�Yerek ONIclel Use only <br /> �., a �� P� � � <br /> own utnorxa ae 91gneWre oste (Ftevsedsr2 01 <br />