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PL.�MIT APPLICATIC _ � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257•8810- FAX 425-257-8857 /p ����2 7 <br /> L� <br /> SITE ADDAESS PARCEL TAX I.O.• PERMI7 M <br /> 2o Gs� z M O�l V - ��l'{ <br /> LEGA LOT N0. BLOCK 7RACT <br /> DESC. <br /> OWNER ADDRESS LP PMONE <br /> Wt ii.�n_ ♦ �ALsd1..TC <br /> TENANT NAME CONTACTNAME PHONE <br /> �SA �L At•�.ovo C�4o ( 4zs) �f38- 3B�Z <br /> CONTRACTOR ADDRESS ZIP CONTR.UCENSEN <br /> C-�n�G¢,�., S1�tr t�t�T � f4G t b l� E. N��.1h� �. 41�b� <br /> PMONE <br /> �+ L � S U220 <br /> PROPOSED USE OF BUILUINQ Building eChanical AOdltian HEA7 SOURCE <br /> PERMIT R�..( Cambinatlon Plumbing WORK Allerslbn [� Electrlc <br /> TYPE �.] Demolitlon Sign TYPE � New G,.j Oae <br /> L.) Sprinkter RepeirlMelnt. L.J Other <br /> CONTRACT PpICE OF WORK `�DD � CtTV OF EVERETT IOCAL SALES TA%CO�E 18 3106 <br /> WORK DESCRIPTION <br /> �►�L'�4c.� �2.) U�o'c. ({ooJS O'UIZIL 'iOM1.T1��L.4 (�{<<l�NdS <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FlXTURE OR REM N0. TVPE OF FlXTURE OR REM <br /> WATER CLOSET A/C-A/HANDLING UNI7S <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANOE HOO� <br /> _ IAUNDFY TRAY WATER FiEATER <br /> CLOTHES WASHER _ METALFIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ QAS FIREPLACE <br /> FLOOR DRP IN _ OAS RAN4E <br /> BACKFLOW PREVENTER _ OAS PIPINO <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREBV CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TFUE AND CORHECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITH WHETHER SPECIFIEO HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTHORIIY TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHEH <br /> STATE OR LOCAL lAW FEGULATINO CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF T IS PRCPERTY TO PERFORM THE WORN fOR WHICFI APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTR CT SLAWIB W{dij12B8,RW��. <br /> � JJ /o Z <br /> ignalu e a wnerl onlraclorl uthonze gent ate �/ <br /> l <br />