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� r { <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-9857 <br /> &TE ADDRESS PARCEL TAX I.D.� PERMIT M <br /> jcr�Z ' L�N6 ��r✓� <br /> LE LOTNO. BLOCK TA/1CT <br /> DESC. <br /> OWNER AD�RE6t ZIP PlIONE <br /> /�'�7 ��b.5N?tG�ioctcii� �Z �f�S,�7c�i;l.�/�(. �Ib'ZO9 �zS ?SK335/ <br /> TENANT NAYE CONTACT FOR PERMIT p1ppE <br /> /��H le�sswFtL Cbr�EZ� I W1,�/�..,av6�L �sr �SZ' 33�r_ �z9 <br /> CONTMCTOR ADDRE89 DP CdITR.UCENSE f <br /> N//+- <br /> PHONE <br /> PRDPOlED U6E OF BUILDIN(i f7�Building I'1 Mechanical I /bdttbn I HEAT SOURCE <br /> �µ..� r�r,K� FERMIT -[] Combination F� Plumbing WORK �Meretion �]�Elei.�tric <br /> ����,,,,,� TYPE D Derrolition IJ Sign TYpE New �j�C,eR <br /> �� Spnnkler RepaklMalnt U ane. <br /> CONTRACT PRICE OF WOR.K � �� �,�xiAZS CITY OF EVERETT IOCK EALE3 TAX CODE IE 3705 <br /> WORK DESCRIFTION <br /> Cows'n�✓r�r Gv�� At,�eoss �'xisn.•/b, ��••�1 � errc�a3',..t.,� 2 saacc5 <br /> I <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM NO. TYPE OF FOfTURE OR ITEM <br /> WATER CLOSE T AIC—NMANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> D�SHWASHER RANGE HOOD <br /> UIUNDRY TRAY WAT[R HEATER <br /> CLOTHES W/15H�R METALfIREPLACEJSTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS FANGE <br /> I = BACKFLOVG PREVENTER = GAS F'IPING <br /> SINK(SERVICFJBAWMOP/ETC.) EXHAUST FAN <br /> OTHER_ OTHER I <br /> I HEREBV CERITIFY THAT 1 HAVE REAO AND E7CAMINED THIS APPLICAI IDN AND KNOW THE SAME TO BE TItUE ANO CORRECT. All <br /> PROVISIONS OF LAWS AND ORiDINACE5 GOVERNING THIS NPE OF WORK WILL BECOMPLIED WITH WHETMER SPECIFIEO MEREIN JR <br /> NOT. THE GRANTING OF A PERMiT CDES NOT PRESUME TO GIVC AUTHORITY TU VIOIATE OR CANCEL 7NE PROVISION OFANV OTHER <br /> S i ATE OR LOCAL REGU TING CANSTRUCTfON OR TNE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> � OWNER QF T IS R O PERFORM TI1E WORK FOR WIiICN APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CGYtRACT S 8.2; CVJAND29G.200WhC. <br /> ,.� (�.—�l ��2"l�� <br /> ignatureo ner! intractor/Aulbonzetl ent ate <br /> i <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I/Z <br />