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P`RMIT APPLfCA <br />EVERETT PERMI�' SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 -- www.everettwa.org <br />SITE ADDRESS <br />�ZS <br />TENANTNAMC " CONTACTFQRPERMIT PHONE <br />f/�L C,��(� �i�� � �uh`r � ��� ���o — �6l 3 <br />CONTRACTOR A�QRESS CITYIZIP PFIONE <br />(S �i� Sl�� <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />f<ilchen sink & disposal <br />Dishwasher <br />Clothcs washer <br />\Naler healer <br />Sink (servicr./bar/mop/elc.l <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />�� /C'/%l`Lef'i <br />aiis,��s� � <br />wc — air hanaung units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ranc�e <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />I hereby cerilify lhat I have read and exe;nined this appiication and know the same to Le true and correct. All provisions of laws and <br />ordinaces goveming this type of work will be complied with whelher specified hereii i or aol. The grenting ot a permit doas not presume <br />lo c�ive aulhorily to violale or cancel the provision of any other state or Iocal law regulaling construction or lhe performance of <br />construction.Pu��� b I am authorized by lhe owner of ihis property to perform lhe work for which application is made and I comply with the <br />Stale CoMraU6(s Law 18.2T,f�W and 296.200 WAC. / <br />