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FC =RMIT APPLICATIC,N <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 � <br /> � 3� - oa� <br /> ISITE ADDRESS �� PARCEL TAX I.D.N ERMIz w� ` // <br /> 1 �( K C A���n� �.2. l✓r ? a 1 OGY.) Ca�, D�o.S'� � :�d �O�7 <br /> I DESC. L0T N0� BLOCK TRACT <br /> �or-k- 1'�c��.s' �8�b� <br /> OWNER 4GORESS ZIP PMONE <br /> c�0 �,� '.,4�1- ct82�C� <br /> � �• �x5-v�. �.-�i =n� �v�� �+-f G�' �ZS �11 ��g�_ <br /> TENANT NAME �NTACT AME ` ��� PHONE <br /> —���._ �—..�e-t�ri�� �c.�.11w�� y--7� 55�59 <br /> CONTRACTUR ADORESS LP CONTR.LICENSEN <br /> PHONE � �� ��� <br /> 'S�'Ctl� � (o <br /> PROPOSED USE OF BUILDING I uilding MeCl�eniCel Addilion MEAT SOURCE <br /> PERM17IT Ccmbinalion �R./ Plumhing WORK Atleretion Eluctric <br /> � � TYPE �emolition U Slgn TVPE New � Ges <br /> L Sprinklar Repair/Meint. Olher <br /> CONTRACT PRICE OF WORK `'7� ��n C�TV OF EVERETT LOCAL SALE9 TAX COOE IS 3105 <br /> hV <br /> WORK DESCRIPTION �� � <br /> Nbw �� '''1 Z <br /> (�A� �c_ aa3a� <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR REM NO. TYPE OF fl1(TURE OR ITEM <br /> � WA�ER CLOSET A/C–/VHANDLING UNITS <br /> BA i HTUB ORCED AIR SYSTEMS <br /> Y' LAVATORY(WASH BASIN) _ HEAT PUMP <br /> I � SHOWER _ UNITHEATERS <br /> � � KITCHEN SINK 8 DISPOSAL CLOTHES DFYER <br /> � Z— DISHWASHER �RANGE HOOD <br /> LAUNDRY TRAY �WATER HEATER <br /> � � CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> � _ URINAL _ FIREPLACE INSERT <br /> ; _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � AS PIPING <br /> SINK �SERVICE/BAR/MOPlETC.) 1 .-EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFY'HA71 HAVE REAO AND EXAMINED THIS APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> Pi70VISIONS OF LAWS AND ORIOINACES GOVFRNING THIS TVPE OF WOFK WILL BE C0IAPLIED W�TH WHETHER SPECIFIED HEREIN OR <br /> N07 THE GRANTING OF A PERMIT DOES NOT PRESUME TO G�VE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STA7E L Al._IANL EG IATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BV THE <br /> OWN T IS PROPE O PERFORM THE WORK FOF WH�CM APPLICATION IS MADE AND I COMPLY WItH THE STATE <br /> C R CT fiS LAW 18.27 R W ANO 296.200 WAC. <br /> -- " � �j/d--� <br /> Sign neol w er/ on�r tovAuthonzedAgenl ale ;"',� , , y �/ <br />