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_ _� _ r <br /> PERMIT APPLICATION � <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 3200 CEDAfa STREET, EVERETT, WA 98201 <br /> 425-257-8010—FAX 425-257-BB57 <br /> SRE ADDRESS <br /> I PARCEL TAX I.D.• RMIi M <br /> ,$0 3 ,r o w P. ooUio�000 o�a. oo � 1 r -� od� <br /> LE6A LOT NO. S��K ��� <br /> DESC <br /> OWNER ADDIIEBS av HONE <br /> �P-c�, N e�'�, 333o M�'0�,,��\ RVe., '���, wA 9�w� <br /> TENAN�NAME I CONTACTNAME PHONE <br /> US, �osT oFF«E <br /> COHTRACTOR ADDRE88 21P CONTR.UCENtE• <br /> Lob,rw CvNs�• C-o. u�w�a�o�z <br /> PHONE /y.r� /�S'�(0� Q� �Y` �a-a�I EVF-F�� GBo��O � <br /> �ow <br /> PROPOSED U8E OFlUILDINO �Bullding Mechenlcal AddNbn HEAT 80UNCE <br /> PERMIT Combinallon Plumbing WORK Allarsllon � Elactrb <br /> TVPE Demolillon � Slgn TYPE New Qee <br /> Spdnkler RepsldAlelM. OMer <br /> CONTRACT PRICE OF WORK ��., � CITY OF EVERETT LOCAL tALE!TAX CODE 1{�106 <br /> WORK DE8CRI ON ��:,�,y � �,� �� <br /> � GxcQ�.�a. � 4- uNdav�;.� ,1;u ��,�dl,� <br /> � <br /> PLUMBING MECMANI AL <br /> NO. TYPE OF Fll(TURE OR ITEM NO. TYPE OF FlXTURE OR REM <br /> WATER CLOSET _ A/C-NHANDLIN4 UNIT3 <br /> BATHTUB _ FORCED AIR 3YSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATER3 <br /> — CLOTHES DRYER <br /> ISPOSAL <br /> _ KITCHEN SINK 8 D RANOE HOOD <br /> _ DISHWASHER WATER HEATER <br /> _ LAUNDRY TRAY METAL FIREPLACElSTOVE � <br /> _ CLOTHES WASHER — FIREPLACE INSERT <br /> _ URINAL — pA3 FIREPLACE <br /> _ DRINKIN�FOUNTAIN QAS RANOE <br /> _ FLOOR DRf�IN OAS PIPINO <br /> BACKFLOW PREVENTEH E%HAUSTFAN <br /> _ SINK(SERVICE/BARlAAOP/ETC.) — OTHER <br /> OTHER — — <br /> I HEREBY CERITIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES OOVERNINO THIS TYPE OF WORN WIIL BE COMPLIEO WITH WMETHER SPECIFIED HEREIN OR <br /> NOT. THE dRANTIN6 OF A PERMIT DOES NOT PRESIIME TO 61VE AUTHORITV TO VIOLATE OR CANCEL TME PROVISION OI'ANV OTHER <br /> STATE OR IOCAL LAW FEGUTATINQ CONSTRUCTION Ofi THE PERFORMANCE OF CONSTRUCTION. TMAT I AM AUTHORIZED BY THE <br /> OWNER OF TMIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH TME STATE <br /> CON7RACTORS LAW 1827 RC1V AND 289200 WAC• <br /> //-5-0/ � <br /> ignelure TbwneU onlrectod ut onzea Mgem ��- �Z <br />