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<br /> . . � GiTY OF�V�R�Tf P�F211lIIT SER�(IGES
<br /> 3200 C�}3AR STR��'I',E�TER�TT,WA 9820'E
<br /> (Pj 425-257-88't0 j �A�42�a-257-88�7 J(E�evereft�ps@ev�retiv✓a.gov� www.e�ie�stfwa.gov/permifs
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<br /> FRt3J,ECT SfT�ADDR�SS: � '- r�t� PE�:�i��EiTI'T.A�C#�
<br /> LEGAL for new eonsfrucfiian: Shor�Ffaflsubdtui�[on LQf No. (aft�ch r�apy of long Iegai desctip#ion)
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<br /> OVff11t�R 1tiiAfli[�: � T�t�IRA1T N�fllt�{1P Commerctal},
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<br /> CDPITR�kCTORL(CEI�IS�#(RE{�Utl�j.. �—°V�2� ' '" . CIT'fDF�VLRETTBUSI�ESS.LicFt�vr�#(R�RUIRETI}: (�j �i
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<br /> i'RIMARY Gt7AiTAGTs R QV1/PI�R `��OhtTRACTOR 17 OTH�I�{Piease�cifjr}
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<br /> F�ts�ng Use or"Building: Confract Prlee of Wark:� ` •
<br /> ' Proposed Use of Buitdin�: Hea#Source: Gas C(Etec#ric Cl()ttier
<br /> Buildirtg 7'ype; 17SFR-l�efached FFi A�fached F��upiex C]Mctlti-�atr�ity-�#of Units: ClGommercial Cllndustrfal.
<br /> Typ�ofProj�et: �(�Ievr �7Addition CiFemadet .p�ir CIl'.f. ClSign CIS zinkfer II[]emolif�on L7Chang�;ofUs� '
<br /> A�SCRIP7'ION OP WC�RK:
<br /> �.�+1,A�ci�`���' � � ���✓
<br /> ASSt?GIATED k3UlLDING P�RiUIIT#{if a plicable): .
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<br /> Type of,�roJeci: ._.R►ew___, .4ddn �1�titeratton ,�Rspair TypeafFrajecf; ____NeY✓ At�dn �AtEerafion ,,,,RepaTr
<br /> �af Lfst,of�J�rture� �of t.isf of Fi'�fures �o� LP�t af�ixtures �°� L.is�of�ix€ures
<br /> Fixfures �ixtures Fla�fur�s P+�ures
<br /> ,41C-Air Ha.n�iting Unifs Neat Pump Toilet Backflaw Prevenfi�r()n,s'cde�Idg)
<br /> Forced Air Sysfems Unif Heafer Bathf�k� Urinai
<br /> Gas Piping _ Baiter Lavafary¢{�l�sh:B�sin} L�iin,king Foun#�cn
<br /> Wafer Heater Rei°cigeration ShoL�r�r Ftoor Drain -
<br /> Gas Fireplace Wood�fove Kitch�:ti SinE�&I1is osa! �rease 7"rap
<br /> Gas�Zange Duc�itig Dishwasher . . RQofDr�ins
<br /> Cla�hes flryer f�taokups Ufher; ° `Glafftes 1Nash�r �tfedica!Gas
<br /> Range Hood �ater�-Ie�i�r Othe�:
<br /> �xhausfFan 5ink�SerYie�/£3arlMo�letc,) C?fher:
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<br /> t�umber of Heads
<br /> ACKIUOINLEDGElf9ENT 1 have reviau�e¢'ffiis appllcation and conffrnl f�is information:con�ine.d herein is tlare and cnrr'ect.�iYork done pursuanf fo fhis parmi�musf comply wr"fh
<br /> cu�ren�fedarai,sfafe,andlocaf(aw.The�ran6ng of a pe�nif only autharizes approved wark and nn deviations therefrom.Deviations must first be auihoiiaed in wrifing from fhe
<br /> 8uilding Qr7"icial before being authorized unzler�at7i+ctroumsfance,!em#he owr�er,pr l am autherized by the ov,�aerof fhis properhj to petform th�wdrk�br 4Yhich applica!ion is rriade,
<br /> and 1 compl.�v✓ith fhe St� Contractore Laur 7 YYantl?96,200I�ViA� .
<br /> Glfy ofEvere#Offfcr�t Use Only
<br /> •E-,�,�i�� '��'�.�~"'�� PERM#T�fi �
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<br /> �v�rr�erlAufhorSzecf Agent SignaY�rs bafe (Revfsed 5120/20�6J: ,
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