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P MIT APPLICATIO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 81TE ADDfiESS � pARCEL TA%I.D.• PERMIT N <br /> as�s w 1���� �-� ��o , oo�a�� � r� , o - o a.. <br /> LE(iAL LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS (� }p PHONE z� <br /> i� ��u �,�5 ���o # 7S�s ' 3� <br /> TENANT NAME CONTACT NAME PHONE <br /> E P.��c�� Ar�f- x - /�l,la� `�a� -aa <br /> �WA�Ond-u�� SyS�rhS ADDqE38 �S� CONTR.UCENSE� <br /> //bv S� 7 <br /> PHONE�S aSS DS Ob /` ��OSS <br /> PROPOSED USE OF EUILDINO Bullding Mechanical qdu:tbn HEAT SOURCE <br /> PERMIT B Combinatlon B Plumbfng WORK � a�en�bn D Eiectric <br /> 1YPE D Demolilion D Slgn riPE New D Ose <br /> ,�a,�/„�y� u Sprinkler Repair/Melnt U rnn.r <br /> CONTRACT PRICE OF WORK ?j D �Q j) CITY OF EVERETT LOCAL OALE9 TAIf CODE IS�706 <br /> WORK DESCRIPTION � <br /> ��,(�t � /lG:C IC//C( <br /> J <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FlXTURE OR ITEM NO. TYPE OF flXTURE OR ITEM <br /> _ WATER CLOSET _ A/C-A/HANDLINO UNITS <br /> _ BATHTUB _ FORCED RIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) ___ HEAT PUMP <br /> _ SHOWER _ UNIT HEATERS <br /> _ KITCHEN SINK R D 3POSAL _ CLOTHES DRYER <br /> _ DISHWASHER _ RAN�EHOOD <br /> _ UIUNDRY TRAY _ WATER HE.4TER <br /> _ CLOTHES WASHER _ METAL FIREPLACFJSTOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN _ pAS FIREPLACE <br /> _ FLOOR DRAIN _ (3AS RANOE <br /> _ BACKFLOW PREVENTER _ 4AS PIPINO <br /> _ SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPIICATION AND NNOW TME SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF L4WS AND ORIDINACES 60VERNINO THIS TVPE OF WORK WILL BE COMPLIEO WITH WHETMER SP�CIFIED HEREIN OR <br /> NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE AUTHORITV TO VIOUTE OR CANCEL TNE PROVISION OF ANY OTHER <br /> S?ATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE PEFFORMANCE OF CONSTRUCTION. THAT I AM AUTHOHIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR NMICH APPLICATION IS MADE ANO I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �-/3 -D/ <br /> Signature ol OwnedContractodAuthonzed Agent Dare <br />