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. P� �MIT APPLICATIQ. - J <br /> CITY OF EVERETT PERMIT SERVICES ; <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 -FAX 425-257-8857 <br /> / � a7 -O� i <br /> SITE ADDRESS PARCEI TAX I.D.N PE MIT w � <br /> /y/6 i/fw�li AYE E�FRIi/ LA Q0939/6k/b360 _ � <br /> LEGA LOT NO. BLOCK TRACT <br /> �ESC. <br /> OWNER ADDRESS 2IP PHONE <br /> R��K LAPiN.SKY P.�: 6ox i97K �YC-�Eir bA 9d�ZvF. y25�33D-'7773 <br /> TENANTNAME I CONTACTNAME PHONE <br /> _ ' �o�nc��-he..,� 42S -y�s3 -5(n5`� <br /> CONTRACTOR ADDRESS AP CONTR.UCENSEN <br /> �v�Ati«> F�/ll- PRc�IECii��✓ n.o svx �s�r s <br /> PyLS� yF�3-S6S7 <xi i'7 l✓��dp��yv�ccc, wA 9ffv7t A�►�ANF/�!%9.�SG <br /> PROPOSEDUSEOFBUILUING PERM�T I—( Sprinklealion R Plumtingal W�RK B RepadMaint. HEATSEU�RCE <br /> � TYPE Demolilion <br /> ftiEjA/G H_ D Sign TYPE New Gas <br /> Ly ome� <br /> CONTRACT PRICE OF WORK � ¢'/� (fp(� .� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> `r <br /> WORK DESCRIPTION <br /> �nsfc�llu ��cn (�� 4 /l�iJ NFPA /3 �rc' S(•�I,nK�r/ syS;�M <br /> PLUMBING MECNi�i:�.^.AL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATEFi CLOSET _ A/C—AIHANDLING UNITS <br /> I BATHTUB FORCED AIR SYSTEMS <br /> I _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> � = SHOWER UNIT HEATERS � <br /> � KITCHEN SINK 8 DISPOSAL _ CIOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> _ LAUNDRY TRAY WATER HEATER U/�/�� <br /> _ CLOTHES WASHER METAL FIREPIACE/STOVE w�L <br /> _ URINAL FIREPLACE INSERT ��� � Yy�_� <br /> DRINKING FOUNTAIN GAS FIREPLACE W .� (� <br /> FLOOR ORAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAFUMOP/ETC.) EXHAUST FAry / <br /> OTHER OTHER ZG Sp/�/lK.l�l �2u2S <br /> I HEREBY CEF7117FY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPEC�FIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT OOES NOT PRESUM1IE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCdL LAW REGULATING CONSTRUCTION OR THE PERFOHMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF TFiIS PROPERTY TO PEFFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORSpAW 10.27 RCW AND 296200 WAC. <br /> / � <br /> ' vn�: fti�n M, I/'nn /-ls-vr <br /> Signalure ot OwneuContrac�orlAuthorized Agent ate <br />