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� <br /> � PERMlT APPLICA � ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 ���`� <br /> n 7 <br /> SREADDRESS PARCELTAlf1.D./ �39� y�y � P,�RMiTk <br /> Z.Zo gr,,,,�iw�y hJL d0 �/39/ - �l��l-pp`�-UI (i - O <br /> �EGAL L07H0. BLOCK TRACT <br /> DESC. l.� . (.�7 <br /> OWNER ADDRE39 ZIP PHOHE <br /> SC� 23ra LI.L Sys_ lobT'' PNC• u6 �-100 �e�\c,n�c,wn`I'uoo�l ZG617i2E�C> <br /> TENANTNAME I CONTALTNAME PHONE <br /> COHTRACTOR : � (�rQ�y� GpNFRAcTuL �ORESS LP CONTR.LICENSE� <br /> RM*�: ST¢✓C�'O5E 970 / �j�� AVG NL fllod GRqNRGLo€OPr/ <br /> PHONE �LOb �j9 aE'�`I SCfYNIt� WA 973��� <br /> � PROPOSED USE OF 8l'ILDIN6 � BuiiEinp D MBCheNCal I QAOCttbn I NEAT SOURCE <br /> PERMIT Combinalion u PlumbinB WORK I> M�Isrelion � E'�ecmc <br /> TYPE Dertwlition U Sipn TYPE D New Gas <br /> Spdnkler � Rapair/Meim. Omn� <br /> , CONTRACT PRICE OF WORK CfTY OF EVERER LOLAL SALES TAX CODE IS J105 <br /> WORK OESCWFTION <br /> bEMOUSH �X �Sr�a� 5'�kc�✓cS <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OFt REM N0. TYP[OF FIXTURE OR REM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB FORCE�AIR SYSTEMS <br /> LAVATORY(YVASN BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 6 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNORV TRAY _ WATER HEATER <br /> CLOTHES WP.SHER METAL FINEPLACE/STOVE <br /> URINAL FIREPIACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS Rl+NGE <br /> BACKFLON'PREVENTER _ GAS PIPING II <br /> SINK(SERVICE/BAWMOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> i HEREBY RITIFY THAT I HAVE R AN9 EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVI51 OF IAWS IJJD JRI�I ACES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED WITH WHETHER SPECIFiED MEREIIJ OR <br /> N0T T RANTING OF A PER DOES 1:0T PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHEF <br /> STATE LOCAL W REG I G CONSTRUC710N OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OW F THI OP TO ERFORM THE WORK FJR WHICN APPLICATION IS MADE AND I COMPLY WRH THE STATE <br /> CO T TO 1 . CW AIQD 298200 WAC. <br /> � � <br /> i Sgn t re of n r nVacl r/ t rized Agent Dal <br /> i <br /> I <br /> � <br /> L �, <br />