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�ERMIT APPLICAT�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX A25-257-8857 <br /> SITE ADDRESS � � /• PARCEL TAX I.D.N PERMIT N <br /> Gc�=�/ . ,��i'G��7-sr�t i;��� Qd3/o -05 <br /> LEGA LOTNO. BLOCK TAACT <br /> DESC. <br /> OWNE , DR 9 <br /> �/d��G�l"%c f �- / J/'�J�E1 �(i//fvi%sst'�'�/�Y� �'1�'� <br /> TENANT NAME CONTACT FOR PEIIMR� / PMON[ <br /> c^C�"�'�.C`/ I ��:c j S! `J?� I�'E• Z2,S'-��( � <br /> CONTIUCTOR ADUREts 21� CONTII.LIClN!@ N <br /> PHONE <br /> �G��%�.,��� <br /> tJ>� �:��'l'./E' <br /> PROPOSED USE OFlUILDINO Bulldirlp MBchinlCel Atldlllan MEAT SOUIICE <br /> rGs . /Y,t,` / PERMrt Combinetion PIumW WOIIK Alroratlon (� ENctrlc <br /> � <br /> �/Gf , � � riPE Demolilbn Sipn � TYrE N�w �) Ou <br /> �. ;���,,.c r�,�,�� Spdnkler Rs{ulrlMafnl. U Olher <br /> CON T PRICE OF WORK CITY OF EVEREIT LOCAL lALpB TA7f CODE q J10! <br /> woNc oEacainnoi+ <br /> )'t'iJ'11Cvc'- l�f1v�� 3G i�k7CS '�/��/�tc' lC'.� �'�%'S// / �`f <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FDCTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A!C-A/HANDLINCa UNITS <br /> 8ATH7U8 FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> � DRINKING FOUNTAIN GAS FIREPLACE <br /> FI.00R DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> oINK(SERVICEIBAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND FXAMINED TMIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> I PROVISIONS OF U1WS AND ORIOINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WMETHER SPECIF�ED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DUES NOT PRESUME TO GIVE AUTHORIT'TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW RLGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICAT�ON IS MADE AND I COMPLY WITM THE STATE <br /> CONTRACTORS-L'AW 18.2YRCW AND 29S.2p0 WAC. - <br /> . . . .�� �: -��;.�._=-=� - - . <br /> �_�.;�" . "�- Lt •.�' <br /> Signaturep wnerl ontrac dAuthonzed Agent ate <br /> / <br /> � DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br />