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► <br /> r — <br /> - F�R�i-r ��PLica �-���n� <br /> � CITY OF E\ll=f�E'tT RERMIT �EP�VICES I <br /> 3200 CEDAH ST^nEET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> - �Pi�' 3��- ��� ' <br /> SITE ADDRESS � PARCEL TAX I.U.q • <br /> '/�O // ��'.�,� FEFlMITq <br /> " bo " o � o 'c�a-� —DO�� <br /> LEGA LOT NO. BLOCK TRACT � (y /' <br /> DE50. S� O� C'�D . <br /> O YNER ADOFy�SS — <br /> ��P �n>4'�P,^;��s �*.c '�a � Pr+c�o ✓ -�f`�?EJ3 12I'�z Z yJ"�J_ <br /> TENANTNAME I CONTACTNAME PHONE <br /> CONTR�CTO� ��.pr,r<-s � D�RESS <br /> �� K J ZIP CONTR,IICENSE N <br /> FHQNEt{. �/ � ! /` //}�j�ry� �/�,��.�:-�:z�Tc <br /> i _ I Z') / ZZ ys��' 3y�� �✓��"(� /V '-�`� � <br /> PROPOSE�USE OF 6UILOING Building Q MeChaniCal Addilion HEATSOUFCE <br /> , PERMIT � Cpmbinalion I ) Plumt7ing \NORK {R-,( Alteralion Electric <br /> �� TYPE Detnolilion � Sign TYpE �.( Now � Gas <br /> Sprinkler U RepaidMaim. I Other <br /> I CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br /> IWORK C7ESCRIPTION (�� r <br /> I �0� r0�7✓r 1� SF� -{x(,G � ��Z� <br /> � � I�D � <br /> IPLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO, TYPE OF FIXfURE OR 1?EM17 <br /> WATERC�OSET _ A/C—A/HANDLINGUNITS <br /> �Z BATHTUB / FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) HEAT PUh1P <br /> � SHOWER UNITHEATERS <br /> _L KITCHEN SINK S DISPOSAL / CLOTNES DRYER <br /> ! DISHWASHER /_ �ANGEHOOD <br /> LAUNDHY TRAY � WATER HEATER <br /> � CLO?HES WASHER METAL FIREPLACE/STOVE <br /> _ URINAL FIRFPLACE INSERT <br /> I = DRINKING FOUNTAIN _L GAS FIREPIACE � <br /> _ FLOOF DRAIN / GAS RANGE <br /> BACKFLOW PREVENTER � GAS PIPING <br /> I ._ SINK(SERVICE/BAN/MOP/ETC.) �? EXHAUST FAN <br /> _ OTHEF _ OTHER <br /> I — <br /> � <br /> I HEREBY CEHITIFY THAT I HAVE R&1D ANO EXAMINED THIS APPLICATION AND KNGW THE SAME TO BE TRUE AND CURRECT. ALL I <br /> , F'ROVISIONS OF LAWS ANO OF;DINACES GOVEFNING THIS TYPE OF WORK WILL BE COM1INLIED VJITH WHETHER SPECIFIED HEREIN JR <br /> NOT. THE GRANTING OF A PER�AIT OOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE PFOVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PEPFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE � <br /> I F OF THI pERTY TO PERFORId THE WORK FOR WHICH APPUCATION IS MADE AHD I COMPLY WITH THE S7ATE I <br />��-� I ONT ., O L W 827 RCW AI}j)pg6.200 WAC. <br /> i � �-r �� � <br /> i ? <br /> , Si n ure of Ow ar/Contractor u orized Agent C�a�e ' �/ <br /> i L <br /> �-\Se;, r. 4� . .. s9�M'�r?'" .�."��# �;; c � ��4t� `.'. r v�`�, ::.' <br /> \ ,� .s�; t '��+ 4 a�,; <br /> \l��<'A��_�.. t `�,..... . � �' t i a �, �,� � <br /> ._. �_.�. a� � k v � .��. <br /> .�'�� ir t�+'yin""i' � �$�` 'a� +.�Gy�e <br /> y.. i� �dn:� ,y a �r!'?"' '* �:�• .n�A �� ` Y�� �� "z''�tel.hY` """.i.�...�w'' <br /> 3 � "'�,.fWs--+�w.. .N .�-'^'- � ' ' <br />'' .:.' _ ..u.� �+__ ._ r <br /> �,�..�� - <br />� ��`'+'-&-� 3` �F. ' ,��P��'f�� � � �.�+ � a ,e a w <br /> i _ i � y a. <br /> y <br />: .. �� . "'� '`'vJti <br /> � ,. � „ <br /> ;4 � <br />. .;:rt.' _ �1 5' .. <br /> _ �h <br /> ., , .�...,. ,o-7.; , . , _: <br /> r* <br />�__ ' '. . .. . . — --_ -- ' r�t,bV�.ln;ti .— . <br />