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� -- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, 'VERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 ; <br /> SITE ADDpESS � PARCEL TAX I.D.A p� I <br /> � /�RMR• <br /> LEOA LOTNO. 6LOCK '- " �b� -w / <br /> DESC. � <br /> NER A�� � <br /> DP WIpNE i <br /> TENANTN E I :ONTACT NqME <br /> C / � PHONE <br /> CONTRACTOR J � �� l/ T P � �`J � �—J I �' �J b�"7 <br /> /,J�eS SP VIGE��/�y.6 fi/II �Cl2U0'(P✓� �i.�' �1fIAI coKrn.uceNser <br /> PHONE � <br /> �1 �.��s 5�°/d S�TQ <br /> PROPOSED USE OF BUILqNG Build.ng � �gp�� �� H�T�� <br /> PERMIT g Combinatbn Plumbinp WORK �Ary�q� I� p�� <br /> TYPE � DemollNon Sfgn TypE � ry�, K <br /> Spdnkler(k W hasds) �••� �°6 <br /> RepeidAAelnt LJ pyp� <br /> CONTRACT PRICE OF WORK /B� �'J CITY OF EVERETT IOCAL SALEB T!J(COpE�g g7p8 <br /> WORK DFSCRIPTION <br /> ����� �r.�,�-�� �f-� ,�c,..��-5 �,t�..��' �-�' r� ca.,Q.c_ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl7fTURE OR REM NO. IYpE pp Fl)(TURE Op�T'EM <br /> _ WATER CLOSET(TOILET) _ A/C—A/HANDLING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> 3_ LAVATORY(WqSH BASIN) _ HEAT PUMP <br /> _. SHOWEH _ UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> _ DISHWASHER _ RANOE HOOD <br /> LAUNDRYTRAY _ WATER HEATER <br /> �, CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL ,_ FIREPLACE�NSERT <br /> _ DRINKINr,FOUNTAIN _ GAS FIREPLACE <br /> _ FLOOR DFAIN _ GAS RANGE <br /> _ BACKFLOW PREVENTER _ GAS PIPINQ <br /> __ SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> _ OTHER _ OTHER <br /> �.� ��o�--_T_� � — <br /> I HEREBY CERITIFY THAT I HAVE READ AND IXAMINED THIS APPLICATIOf�AND KNOW THE SAME TO BE TRUE AND CORqECT q1.1 <br /> PRO��ISIONS OF LAWS AND ORIDINACES OOVERNING TH1S TYPE OF WORK WILL BE COMPLIED WRH Wh1ETHER SPECIFIED HERQN OR <br /> NOT. THE G7ANTING OF A PERMIT DOEu NOT PRESWAE TO 61VE AUTHORITY i O VIOLATE OR CANCEL THE PROVISION OF�WY OTHER <br /> STATE OR LOCAL LAW RFGULqTING CONSTRUCTION OR THE PERFORMANCE OF CONSTAUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER CF THIS PROPERTV TO PERFORM T}1E WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH 7HE STATE <br /> CONTRv.CTORS LAW 18.27 RCW AND 298200 Wq�, <br /> ��i�cE' ,,,,..�-� � - 3 O 3 <br /> Sigrature of Own r l.ontractor Aut onzea Ag,ent ata <br />