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� <br /> I <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-BB10-FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.tf.A PERMIT N <br /> �')// C9/��orn�4 f�vL oos93663) 000Q o - 00 <br /> LE6AL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER 1 ADD E88 PMONF <br /> �Vi.r�7 �✓S/.c St�r/LS �'!'!�O � / 0 <br /> / yQL'S <br /> TENANT NAME I CONTACT NAME 1 .J PHONpE� <br /> Avf �l��h SLMdJL StfV/c[S S�G�.C� /xO�/� '7Ir� 7�6"06� <br /> CONTRACTOR ADDRE88 CONTR.LICEN8E� <br /> ,BLIy Ntu✓ [ o pu, dwc S"rL$ ,6'L�r�r,�co77CM <br /> PHONEt/ZS'- 77G�g83.Y L7/r••��•.o.A � �--'� ��Y� <br /> PROPOSED USE OF BUILDINQ n Bulldinp MechenMsl Additwa HEAT SOURCE <br /> Scl,oeL l3��5 PEiiMIT f�5 Combinallon B Plumbinp WORK � IUterotwn D Eiactric <br /> TYPE Demolillon �'Sipn TYPE .D'Aew I� aae <br /> B Sprinkler U HepsldMelnt. U Olher <br /> CONTRACT PRICE OF WORK ,g 3� �O CITY OF EVERER LOCAL BALE8 TAI(CODE 18�106 <br /> WORK DESCRIPTION j�.,${n t c C�� �Vv,V- 4'+ Sisn .�i�r.� 4.:t�i,v�,�r� <br /> PLUMBINp ��-� <br /> NO. TYPE OF FlXTURE OR REM N0. TYPE OF FlXTURE OR ITEM <br /> WATERCLOSET _ A/C-NHANOLIN(3UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 3 DISPOSAL _ CLOTHES DRYER <br /> DISHWASH[R _ RANOE HOOD ��, a <br /> LAUNDRY THAY _ WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT a � � <br /> _ DRINKINO FOUNTAIN pAS RANOE CE ��-� <br /> FLOOR DRAIN -- <br /> BACKFLOW PREVENTER _ OAS PIPINO <br /> _ SINK(SERVICE/BAR/MOP/ETC.) — OTHERST FAN � ,/�� <br /> OTHER . — �I <br /> I HEREBV CERITIFY THAT I HAVE READ AND EXAMINED THI9 APPLICATION AN�KNOW 7NE SAME TU BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES 60VERNINO THIS TYPE OF WORK WILL BE COMPLIED WITH WHETMER SPECIFIED MEREIN OR <br /> NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE AUTHORITV TO VIOUTE OR CANCEL THE PROVISION OF ANV OTFiER <br /> STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PR NTY T ERFORM RK FOR WHICM APPLICATION IS MADE AND I COMPLV WIiH THE STATE <br /> COMAACTORS 1B. � <br /> t o wner/ onirector ut odze gent 1e li <br />