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� ERMIT APPLICAT�JN � <br /> CITY OF EVERETT PERMIT SFRVICES <br /> 3200 CEDAr� STREET, EVERETT, WA 98201 <br /> d25-257-88t0 - FAX 425-257-BB57 � <br /> � �r �p���� •O/� <br /> S�TE ADDRESS PARCEL TAX I.D. N vERMI M <br /> 393 � �� or�• y���i�T-a.>--� -o <br /> _E .1� ' LOT N0, BIOCK TRACT <br /> ...�.; / S�/ C�tyJw�4� �./Ava �j�J <br /> ON'NER ADDNES LP PHONE ' <br /> -�`%E� �K'a�,PS� a 7 3/ l•��T'N�o RC �1v G-�-I"' Y���r �'o$"-3E3 f3 •0.2 d f <br /> 7ENAM HAME CONTACTNAME PNONE <br /> _ STc� r,�t�x'�1Lf I�aur [.Z.z� f'.rr-4r��-�.�ts— <br /> CONTRACTOP ADDRE55 LP CUNTR.UCENSEI <br /> G�/G�7�%/tYN CaM S��"+�enlrJy .i' /35 <br /> c��/b FC. r�'Cx// <br /> vn04E <br /> f/�r y�ifi.zs s' /36Yc ��}'' Ab� .�r.t h'.l�+s��.?..� �i 9PoPy i <br /> aR0�O5E0 USE OF BIAlDINO Bu��dmp MechamCal AOadbo MEAT SOURCE <br /> I n �a <br /> PEpMfT R Combinetpn R Plumbing WORK �-A�teratwn (�j-EiectrK I <br /> TYPE ❑ DomolAion D Sign TYPE D Naw ❑ Gas <br /> ��,N� U Spnnklor 1�d heaC��) U iiepair;Ataint. �� Other �� <br /> CO�(TRACT PRICE OF WORK �W v v� CRY OF EVERETT LOCAL SALES TA%CODE 15 J105 <br /> wOHK OESCHIP'T10N �1�� ��' ,GI/-�^-��DY�� <br /> /',�ou•4r .�s�►.o�yy Accdlr /3NT.� a-��,:yy � <br /> /S'c'�n✓•-rt r-r?e'�?�..YiJ C�'•.�Ti.. �.�.,ywr /zr i.�..2X.u- GY�Ta'�c .rrY��L <br /> PLUMBING MECHANICAL <br /> •�O. i TYPE OF FIXTUpE OH tTEM N0. � TYPE OF FlXTURE OR tTEM j <br /> i <br /> �(. WATER CLOSET(TOILE7j _ /4'C-/tiNANDLtNG UNITS <br /> _� BATNTUB _ FOFCED AIFi SYSTEMS <br /> .jt 1IIVATORY(WASH BASIN� MEAT PUMP � <br /> S1iOWER UNIT HEA7EfiS <br /> _ Ki7pr�N SiNK 6 D�SP lOTyBS DRYER <br /> = Di5M�YASMER �HOOD i <br /> LAUYDRY T JA HEATEF <br /> GLOT�E$ ASHEA METAL REPLACE'STOVE � <br /> UAINAL� �� _ FIREPLA ItJSERT <br /> _ DF�iK���G FOU?�TAM _ pAS F�REP 'E <br /> PCOOR DPAfTJ � _ GAS RANGE <br /> ,� OACKFLOV/PHEVEN ER _ OAS PiPIN� <br /> �=_I SiNK(SERVICE'BA /ETC.) EXHAUST FAN I <br /> OTHER _ OTHER <br /> �E.�EBY CEp1TIFV 7MAT I MAVE READ AND EJfAMINED TMiS APPLICATION AND KNOW TNE SAfdE TO BE TRUE AtdD COP.RECT. ALL I �I <br /> -'��✓ISION9 GP UW$AND OPIDINACES OOYERNIN6 TNIS TVPE OF WORK WILL BE COIdPUEO WITH WNETHER SPECIFI[D HEREIN OR I <br /> .. ? iHE GRANTitIG Gf J1 PERIdiT DOES NOT PRESUTAE 70 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFOVISION OF ANY OTHER � <br /> �,ttT E pq�p�A�iAW REOVU?INO CONSTRUCTION OR TME PERFORMANCE OF COt15TFUCTION. THAT 1 AM AUTHOR12ED�Y THE <br /> _.��.ER Of TMiS PR6PERTY TD PEHFORM TME WORK FGR`NHICN APPLICATION IS IAADE ANO I COMPLY WITH 7HE STATE <br /> .r,'�iRAGTC UW18.27NCWAND2S92GOWAC. � <br /> i�'/y-v 3 ' <br /> S�p wre ontracton �nnonzao qant ate ��� <br />