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� I,o°" -!2 / <br /> PERMIT APPLICATI�N <br /> C�N OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, Wq g8201 <br /> 425-257-8810-FAX 425-257-8857-www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM e AIN TO 4 PM -DEBIT i CREDIT CARD3 ARE NOT ACCEPTED <br /> $�TE ADDRE9S <br /> 4ilc, �( t►�a.'k�'. � �ZI3 P�ncc�re i.o.N <br /> cwHu vsa a'� rzm PERMITA <br /> LEGA LOTNO. SLOCK TRACT �� <br /> DESC. �' � �� <br /> ,Anrinc l..e�,,,ry�.ecu, C�r� lalp�r. "�- �,,e� 'b�yq ''�- <br /> TENANTNAME I CONTACTFORPEItMIT � �` <br /> MIONE <br /> CONTRACTG� a, ADDRE!! <br /> CITY2IP ���p� <br /> corna.uceti�er KAIAR$RO�(aKL I�l"181• 13� $Y-NE ���.� � <br /> 3c.u- (.ql-"7a�IS <br /> uae oF eui�oiNa -S <br /> � HFr�T�RCE CONTRA�T PRICE OF yypRK <br /> /!ES/Dri+�J�y^L �r Electric _(3as_Othe� �15� <br /> WORK DESCRIPTION <br /> 1:v,r7-•0� c G'c✓ �..�c �i�Tn Heurg ��2 yoTw,pTt',c' <br /> �n-f'r�OLc, iVt �✓ C�o.J" �/dT t..,�jt"�t • ``J"�v ..vr <br /> �t/N �.QT L�iv� 7AiV4i ip ti.�� iit�,f'Cj7T' /iV ,�..� <br /> Td [.P.iTip/E�• ri.PtpG.Oc�� T <br /> PLUMBINO ' <br /> NO. TYpE OF FIXTURE OR ITEy M CHANI AL • <br /> _ Tollet �� ���a�OR IfEY <br /> _ Bathtub _, A/C-air handlinp urNb <br /> _ LavaWry(Wash baaln) Forced drsy�t�s • <br /> — Sh°�+'e� Gas pipinp <br /> _ Kitchen eink 6 dispoeal � Watsr h�ater <br /> _ Diahwaeher � Caai flroplacs <br /> _ Clothea waaher _ C,a�prp� <br /> _ Laundry UaY _ Cbtlroa dryer <br /> _ Sink(eervice/badmopletc,) _ Ranps hopd <br /> _ Backflow preventer _ Exhawt hn <br /> _ Urinal _ Heat pwnp <br /> _ Drinking Fountain _ Unlf hsater <br /> _ Floordreln _ go��a <br /> _ Greaae trap _ Refrlpsratbn <br /> _ Roof draine _ yyp���Ve <br /> _. Other _ pqia�— <br /> �_ <br /> CITY OF EVERETT lp�k a�Es��C�y»0e <br /> I hereby ceriGfy thaf I have read and examined thle applicatlon and krpw fhe sams tp be tr�o�d�� al <br /> ordinaces goveminp thia type of work wlll be complied with whether epectfled herei�or not.Ths prandnp of a <br /> lo give authoriry to vlolate or cancel the provlalon of any othx etate or bcal law �N�M a I��� <br /> consWctlon.7hat I am authorized by Ihe owner of Ihia ro e to r(urtn tl�e��uf�����°��0��������t prp� <br /> State C traqora Law 1 . 7 RCW and 298.200 WAC. p P � � aPW�atlon It m���pm���� <br /> S 4'nature ner tractor u o z L" <br /> ent A ' <br />