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/ <br /> PERMIT APF�LICATIO�V <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> SIT ADDRESS PARCEL TA%I.D.N PERMIT M <br /> ;�9 C rnlo k� �C„ ��r,w� #adsy�7m���io� so�oq-oo <br /> LECiAL LOT NO. BLOCK TRACT <br /> DESC. <br /> O\'YNER ADDRESS PMONE <br /> !r V�:"7Z.tT /N✓cSfhi�/l� �C Z�9 PAS�NO �O� t'!/r7Z��1�If' � ZL1''�300 <br /> 7ENANT NAME CONTACT NAME PHONE <br /> r��,o,� ,��,�f �-�� k�s 33�.�,ba <br /> CONTRACTOR AQURESB CONTR.LICEN8Ep <br /> PHONE <br /> PROPOSED USE OF BUILDINa Building �Mechanicel naditron HEAT SOURCE <br /> PERMIT � Combinetion Plumbing WORK B Atteretlan D Electr�c <br /> S�y��/�M�. TYPE Demolitlon Slgn TVPE D New U 6aa <br /> Sprinkler U Rapalr/Ma1nL U omer <br /> CONTRACT PRICE OF WORK CITY OF EVENETT LOCAL 8ALE8 TAX CODE 18 3105 <br /> WORKDESCRIPTION �N�j� �� L7�1r,/� S/61J Z �X IZ � 0� -n� F�1't'� �'' <br /> 'f�}e ?,c1��p�n/t, . <br /> PLUMBINO MECHANICAL <br /> Np. TVPE OF FU(TURE OR ITEM N0. TYPE OF FlXTURE OR REM <br /> WATER CLOSET _ A/C-A/HANDLIN4 UNITS <br /> _ BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASI�y _ HEAT PUMP <br /> SHOWER / _ UNIT HEATERS <br /> _ KITCHEN SINK 8 OSAL _ CLOTHES DRYE�'�-- <br /> _ DISHWASHER RANGE HOODf <br /> LAUNDRY T WATER HERTER <br /> _ CLOTHES A HER METAL FIREP E/ O� <br /> _ URINAL FIREPLACE INS <br /> DRINKI G F NTAIN � OAS FIREPLAC <br /> FLOOR DRAIN _ QAS RANOE <br /> _ BACKFLOW PREV TER _ GAS PIPINO � � � � IZ <br /> _ SINK(SERVICE/B R/MOP/ETC.) EXHAUST FAN IS D <br /> _ OTHER _ OTHER <br /> — — P ;' . „�n� <br /> I HEFEBY CERITIFV TMAT 1 HA'JE READ AND E7(AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRDEIIN�CORRE�j <br /> PROVISIONS OF U1WS AND ORIOINACES GOVERNINO TMIS TYPE OF WORK WILL BE COMPLIED WITH WHETMER SPECIFIEb H� EIN OH <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO QIVE AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTHUCTION OH THE PERFORMANCE OF CONSTRUC110N. THAT I AM AUTMORIZE�BY THE <br /> OWNER OF THIS PHOPERTY TO PERFJRM TIiE WORK FOH WNICH APPLICATION IS MADE AND I COMPLV VY�TH THE STATE <br /> CONTRACTORS lAW 18.27 RCW AND 298.200 WAC. <br /> , 9/�/ <br /> Signalure of wner/Contractor/Authonzed Agont Dat ,/ <br />