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P RMIT APPLICATIO�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETl', WA 98201 <br /> 425-257-8810-FAX 425-257-$857 <br /> SRE ADDR PARGEL TAX I.D.A PERMIT r <br /> � 7/ e � �v , � �a�O� a-- <br /> LEOA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS aP PHONE <br /> h'I�ia���i-t�wn �i' 7/7 �9�'�r�s�' pr� ��f' 982�3 yZ�' 339 9�r9 <br /> TENANTNAME I GONTACTNAME PHONE <br /> COI�RRACTOR ADDRESS 2JP CONTA.UCENSE• <br /> PHONE O��— <br /> PpOVOSEO USE OF BUILDING Buflding Mechenical Additlon HEAT SOURCE <br /> PERMR Combinetbn Plur�ing WORK RL,7Alteretlon �ectrk <br /> 7YPE Demolition � Sign 7YPE �y New � Oee <br /> Sprinkler U pepeldAAalm. ou�x <br /> CONTAACT PRICE OF WORK GTY OF EVERETT LOCAL SALES TAX CODB!8�106 <br /> WORK DESCRIPTION <br /> �G�� �-Gy�,�y�$/ Yi_ <br /> PLUMBING MECHANICAL <br /> NU. TYPE OF FlXTURE OR REM NO. TYPE OF R%TURE OR REM <br /> _, WATER CLOSET _ A/C—A/HANDLINCi UNITS <br /> _ BATHTUB _ FOflCED AIR SYSTEMS <br /> _ LAVATOFY(WASH BASIN) _ HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> __ KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> _ DISHWASHER _ RANOE HOOD <br /> _ LAUNDRY TRAY � WATER HEATER <br /> _ CIOTHES WASHER _ METALFIREPLACFJSTOVE <br /> _ URINAL FIREPLACE INSERT <br /> _ DHINKING FOUNTAIN � OAS FIREPLACE <br /> _ FLOOR DRAIN OAS RANOE <br /> _ BACKFLOW PREVENTER ,�j� Qqg PIPIN(i <br /> _ SINK(SERVICE/BARIMOP/E'TC.) _ EXHAUST FAN <br /> _ OTHER _ OTHER <br /> — — — � <br /> I HEREBY CERITIFY THAT I HA�E READ AND EXAMINED THIS APPLICA710N AND KNOW T.-;E SAME TO BE TRUE AND CORFlECT. ALL <br /> PFOVISIONS OF LAWS AND ORIDINACES OOVERNINO THIS NPE OF'NORK WILL BE COMPIJED WITH WHETHER SPECIFlED HEREIN OR <br /> NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO OIVE AUTHORITY TO VIOUTE OR CANCEL TNE PROVISION OF ANY OTHER <br /> STATE OR LOCAL lAW REGULATIN6 CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. iHAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY'TO PEfiFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> COMHACTO 27 RCW AND 288200 WAC. <br /> �' ����� <br /> a ure o er ontrsctor u z ent et� <br />