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1'OV- 19-2N10 ill :0; Fi:•1 SFIOHOI•lISH. ENERGY 36G 56.T, 9131 P. 02 <br /> d <br /> \ . <br /> PERMIT APPLIC�►TION <br /> CITY OF EVERET'f' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257•8810—FAX 425-257-8857—www.everettwa.org <br /> APPIICATIONs ARE ACCEPTED FROM!AM TO 4 PM �� _� �J--/(� <br /> �ITE AbDRE88 PAP.CHL TAX�.D.t1 PERMIT N <br /> �,� , l U l - �t <br /> LEOA LOT NO. lLOCK TItACT OR�UOWVI610N/ <br /> DE3C. <br /> 0 I ZP PHONE <br /> �`' �rv� Zc�a"�.oi � �1.��CL <br /> TENANT NAME I�NTACT�OR��IIMIT PHONE� C�3�Gt�C�c/ <br /> liIAIL �C <br /> 'Z!aNTIOCCT � <br /> :atiol��ov���ln &.�ar(J�J �,�,?'� ��( � '�/�.�`y��,�� , �3br'�5rvp3(�- : <br /> CONTR.UCENBE���OLCV G �I.Sa� �[X �� -JL�Y V �Lfh..�� �I. 1 1 <br /> UBE OP BUILDINO I — HEAT SOURCE I CONTRACT PRICE OF WpRK <br /> ElocUfc _Oae_Other ����� � <br /> WORK DE8CRIPTION ��,L � �� 1,,, J �1 �' ,y,' ,� ,�,^� ,f�i r �G��,� _/) � r- <br /> i�o�-� ri�r� �,[�vl�l �.� rr �r.Ei.�e. <br /> PLUMBING C A I AL <br /> N0. TY►!0�FIXTURE OR ITEM NO. TYYE OF fIXTUR[OR IT[M <br /> _ ToGet A/C-sirh�ndllnpunRs <br /> _ Balhtub ^ Forcedalray�tim� <br /> _ Lavetory(wesh basin) _ Gaa pipinp <br /> Shower _ We1er Mater <br /> _ Kilchen slnk 8 dlepoeel _ Ga�}Iropliu <br /> _ Dlshwa�hcr ,� Op�renpe <br /> _ Clothoa waaher _ Clathes dryar <br /> _ Wator haeter _ Renpe hood <br /> _ Sink(eerviceibaNmop/etc.) 6chau�t hn <br /> _ �ack'owproverter Heatpump <br /> _ Urinel _ Unit healer <br /> _ Odnking Founlein Boiler <br /> _ Floortlraln _ Refriperetlon <br /> _ Groa9e Irep __ Wppd�toy6 <br /> _ Roof drafns _ Other <br /> Other <br /> CITY OP EV[lI�TT LOC1L O�IE�TA%CCD�I!7706 <br /> I hureby cnAlty thet I have feed end ex�minad thie applicetlon and know th��ems to be true ond CorteCt. All provlslc�a of laWe ond <br /> ordinance�goveminp thia type olwork will be complled wlth whether�pxLletl hereln o�nol.The grentlng of o pormit dus not prcwme <br /> to Blvo 6uthority lo violate or cancel the provl�lpn of�ny other�tata or Ioeel Isw repuleting conelruCtion or the pertormance Ot <br /> toneWction.Thal I nm authodxed by the owner of thl�propeMy to pedorm tha wotk lorwhich appllutlon li made and I wmply N1th lhn <br /> Stete Coniradon L�w 78.27 RCW end 7B8.200 J�AC. <br /> ��� � c�.��,�— �1 ��� 1�o <br /> o�gnaturoo ed tractoVAuthorziH gent Dele <br />