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ioiaoioi ii:ss Fea �ooz r <br /> ; <br /> PERMIT APPLICATI�N ,� <br /> CITY OF EVERETT pERMIT SERVICES <br /> , <br /> 3200 CEDAR STREET, EVERETT, WA �J8�01 <br /> 425•257-8810—FAX A25-257-8857 i <br /> e <br /> 5(i'E AOURESS � PARCEL TAX I.D.N � PERMI7 M ' <br /> �� l� ��/ ✓e��� .. Moi1�;�5 I� <br /> LEG LOT NO_ BI,OCK TRACT ' <br /> DESC. ����Gi {-y'�-L <br /> OWNER ADORESS Zip p NE - � <br /> MGMAg �ro 3 � lo� � �,�- NE i��Ge��.e. w� � g�ti <br /> TENANTNAME CONTACTNA4F pNONE <br /> �+�C � S� Z � 1��, �cf�.s�— (zs���iz��y L ; <br /> CO CTO ADDRESS CONTR.UCENSE/ ' <br /> �e� l�n�P��C�vi.� c�.( la 4 '�o (DB�= flv� s ��n .� Gv�a K6YM�kr�K z4 IJ� ' <br /> PMO '�1g�3 Z <br /> �`� '_ Z-7�,5 z� � <br /> PROPOSED US@ OF 6UILDING � Bulldltlg �Q.MBCh9nical n py�ittan HFAT 90URCE <br /> I PERMR COmbinelion PlUfnbiny WORK k{119 Alleraiwn EIeCItiC <br /> TYPE Oemolftlon B Sign ' ITYpE �..J New � Gas <br /> Sprinkler � I� nepaidMatnt LJ omdr <br /> CONTRACT pRICE OF WOqK O ( oQa Q'c� CITY OF EVERETI'LOCAL SqLES TAX C06815 31p5 �� <br /> ! <br /> WqqK DESC PTIq N „ � • . <br /> �e f✓ ���-m.�.�i-�. �Q,V��aL r � �r�,4-,rz �w5E-,n--a, vr�iy �vc�� ; <br /> d�n.�cu.� c�s� S or� i�ny�+.c� r�w lw yx c��x ei��5,r-:.,� cz� S . ; <br /> W 0 �f �2�.�atM,,Ca1 V�d�'�- �� � � {,vc��c�.. ..(�'iiP�c S�5 l. ,, <br /> ' PLUMB G i ME A ICAL� � <br /> NO. 7YPE OF FlXTUqE OR ITEM � <br /> • N0. TYPE[7F F%TUR@ OR ITfiM <br /> � WA'TER CLOSEf ' _ A/C_q��-�pNDL1NG UNITS <br /> — BATt�rUa ` FORCE�I AIR SYSTEMS � <br /> _ LAVATORY(WASH BASIN) ,: NEAT PUMP � ! <br /> _ SHOWFR _ UNIT HEATERS : j <br /> � KITCHEN SINK&pISPOSAL _ CLOTHES DRYER % <br /> _ DISHWASHER � qANQE HpO� i j <br /> � UIUNDRY TqAY _, WATER HE47ER� i <br /> � CLOTHES WASHER _ METAL FIREPL4GE/STnUF � <br /> _ UFiINAL , FIREPLACE INSEIiT <br /> � DqINKING FOUNTAIN _ GAS FIREPLACE' <br /> _ FLOOfI Df1AiN � GAS RANGE � <br /> _ 6ACKFLOW pREVENTER s GqS PIPING <br /> _ SINK(SEqVICElBAFi/MOPlETC.) � EXHAUST FAN <br /> _ OTHER _ 07HER <br /> _ ._ ; <br /> _ <br /> i i�CR[oY CeRi7ifr TH�T I w4Vp REno p7vD E7cpnnlNtu IHIS APPLICATION ANO NNOW TNE SAMH TO BETRUE ANO CORREC7: qLL <br /> PROVISIONS OF LAWS ANO ORIGINACES GOVERNING TNIS TYPE OF WOFK WILL yE COMPLIED WRH WHETHEA SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMff t7f1F.$NO7 PRESUME TO GIVE AU7HORI7Y TO VIOUTE OR CANCEI.THE 1°ROVISION Uh ANY U�FIEfl <br /> STA7E OR LOCAL LAW REGULA7ING CONSTRLICTION OR 7HE pERFORMANCE OF CONSTFIUCTION. THAT I AM AUTHORIZEp 9Y THE <br /> _ OWNER F 7HI5 PHOPERTY TO PERFOFM THE WOAK FOFi WHICH APPLICATION IS MADE AND I COMPLY WfiH 7HE sTATB <br /> CQNt RS LAW 18.Z7 CW ANU'L�Jtl200 WAG. <br /> , l D `� a-i <br /> Signa ure o�OwnedCo IraclodAulhorized Agent Date <br /> ! <br />