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, <br /> ( �PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.t PER IT� <br /> �, ,,�,,�,� �,u� . I .�/16�39 <br /> LeGA LOT NO. BLOCK TRACT <br /> DESC. t�4 2f� -7'13 <br /> O NE ADDRESS LP PMONE <br /> u�G�c� w�'Jtuo�.ce�.��t. I'�z-1 c�x.aSY �w� `�d Zvl `fv�^• t4�.c�3 <br /> T�NA�NT�NAME .�'J - n�� CONTACT ME PHONE <br /> ��jl f r�vrr ey1�3a�4�A'1..K'�YO•� 1 '� �i ' � '�If�J <br /> A9'JtMYUC� U.-{�w �uG � <br /> CONTRACTOR ADDRESS LP COIIfR.UCENSE I <br /> PHONE <br /> PROPOSEDUSEOFBUILDING Building � Mechanical Addition HEATSOURCE <br /> PERMIT Combinetion Plumbing WORK Alleratbn [� E�e��ric <br /> �y1�YJlGRflr riPE Demolition Sign TYPE � New �p Oea <br /> Spdnkler U RepeidMaint. I.J otner <br /> CONTRACT PRICE OF WOFK �(�� ' m� CITY OF EVERETT IOCAI SALES TA%CODE 18 J105 <br /> WORK DESCRIP710Y <br /> ��,o,,.,� i w�(4'7i�,s+ti.�a.r�.(�I i�4���1''� ¢ �' G�-�i�' r'h'l�IC''' c�C`I�'' ���sO f'f`p`'vt' ¢jt�!' <br /> I�N 1nk�,�n�.�'s p�r.��c.4+.4nn,c►.�s c��2 Aq �►2°vi✓J�vct, kwft�TT'v�'�'� �aoa. �t.�-�feit..- <br /> 1�PGtft� �f�µs <br /> ' PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR REM N0. TYPE OF FlXTURE OR ITEM <br /> WATERCLOSET "" A/C-AlHANDLINaUNITS <br /> -� BATHTUB / FORCED AIR SYSTEMS <br /> 2 LAVATORY(WASH BASIN) �_ HEAT PUMP <br /> ^ SHOWER = UNIT HEATERS <br /> • ^ KITCHEN SINK 8 DISPOSAL = CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDFlY TRAY � WATER HEATER <br /> CLOTHES WASHER � METAI FIREPLACE/STOVE <br /> � URINAL � FIREPLACE INSERT <br /> ^ DRINKING FOUNTAIN = �AS FIREPLACE <br /> " FLOOR DRAIN = GAS RANC3E <br /> BACKFLOW PREVENTEFi �- 6AS PIPIN6 <br /> jQ__ SINK(SERVICElBARIMOP/ETC.) � EXHAUST FAN <br /> OTHER � OTHER <br /> I HEFEBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TI IE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF I.AWS AND OHIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE AUTHORITY TO VIOLATE OR CANCEI TME PROVISION OF ANY OTHEH <br /> STATE OR LOCAL L�W REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF TFIIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR��T 5 LAW 1827 RCW AND 296.200 WAC. <br /> �/ N�ti/a <br /> Sign 1 re o Owner/Contractor/Authonze Agent e /[ <br /> /L <br />