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( �, <br /> � PERMlT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEbAR STREET, EVERE7T, WA 98201 <br /> ���ru� C;� 425�257-8810—FAx 425•257-B957�www•everellwa.org <br /> ; c� . �� APPLICATIONS ARE ACCEPTED FA0111 tl hM TO A PM 3 �17.Oa <br /> �v <br /> SITE ADDRE88 PARCEL TA%I.D.• r <br /> ., C 3 � v <br /> LF.QA LOT NO. BLOCK Ti111CT dl SUBDIYI810N l <br /> DESC. <br /> — • OflR69 � V M <br /> � ..��OfArt�l�l '�� 1i} /'•�•�,�. '� ';�Kl�it 1A�1'W3 �{�ll.�.y1�li.11010'1�_ <br /> p1ANTN/�M! � CONIACTF9RPERM� K � PHONE � �'�� �� <br /> ' -COPTR���f/�j,��G, _ VA�SS 1�C{ff�G E•MAIL 1 OO�V��� <br /> ��.,...:-r L'� '_'—PH6R�- <br /> FanAWG�b�'�f'�Nfi'COP��'.�NC• <br /> CONTR.Ii us p,�IMv�fCcr��af,�Rd 'jQ1(�A�L�'i�tl11 �?1� �fY �b�i�'1�i1.AC�11 <br /> U3E OF BUIL�INO I HEAT 90URCE I CONTq�GT VAICE OF WORK <br /> �1Q.��11 V , �y�yy�(�hC7NEl1� iliS�I —Elechio _Qys�aher (�(,�� '�j/� <br /> WORK DESCRIPTION <br /> ���i� ���� HANICAL <br /> PI.UMBINCi <br /> N0� 7YPCOPflYTURE0qI7EM H0. tl'PEOFFPITURLORREM <br /> Tolle� _ A.0_91r Umitllin�unMS <br /> Bathlub _ Fc�r.aO�rcysr!m3 <br /> � Lavalr.ry(wash b�smS _ Oe:Pipinp <br /> Sno•�vrr _ Wa�ai neahi <br /> KIl�P1151N(b dI9p0981 0761i19FIBCR <br /> Gishwnsher _ Osy renpe <br /> Cianas waclier Cblhee d�yer <br /> — v:�w�nealer = fianpeAood <br /> Sink•,yervicebadmop'elc.� Exhausl lan <br /> � n;,�;clw��P�venter _� Nealpump <br /> � Udnal _ Unit hedter <br /> � pdnhinq Faumw� _ 8oiler <br /> � Floor drain _ ftelrlperallon <br /> Oreaselrnp _ Nl0od8tove <br /> RoolOtain9 _ Olher <br /> Other — --- <br /> CIN OIfVEnerfLOCAL9ALESTAXCOD�19f1D3 <br /> I <br /> I he�uU�curiti�y inai I��ave ieatl and exarnined this ey�p���ninn and know the same ta Oe true ana corracl. AO prosi.ton:d la�+s ana <br /> ordina,-p;po��erninp�nis rypo oi�vork will be comphvd wnn urn?war specilied hemin o�nol.t�e grenling ol a Denml does nol pmv�me <br /> to gh�a nuihr••dy ro woi�te or cancel the piovlston ol hny um��siaa a�iowl law repuialn9 mnstwclion or thn perbrrnan�p al <br /> con ,cPo�� a�I dm auth ' ed hy the avrner d in�s Gropany m peAorm�ha wvrk�or Nt�ch applicalion Ic roade and I�.,r,ipry wdn Ina <br /> S a nnl� t s '� 18 CV!end 29d 20n WAC <br /> � !^"��- <br /> „pn rg010v+r1 dConir cNr.. ul o cad flant a�e <br />