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C f ' <br /> . � <br /> PERMIT APPLICATION ; <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT,WA o8201 <br /> 425-257-8810—FAX 425-257-8857 � <br /> SITE ADDREa3 PARCEL TAX 1.0.f �• <br /> �703 Ne.�.it A�c-_ �� 3 /66� GC9� J j0�- <br /> LOT NO. SLOCIt 1MCT <br /> ��� 9��3� <br /> - � � yr�es+ <br /> UIINDEME2E C�o�^MC2C_�AL �7/U� E�c�c �ecn W 98Zo3 <br /> 7ENANT NAME 1.��'s.a...sfw ear � r>� CONTACT F011 PEMNT MIONE <br /> P��..l k�-��sk� M�.;.� �c�ic. S�SnS 4ts • 3S3 • SSS'7 <br /> c°"nucroa I�'��1... JV�d1 c�. AD°�°' (09 23 E�5 re��ar coM�w.uce��c� <br /> ,,,� rwrn�M+��ye��2 <br /> M10NE yZs • 353• SS`�7 � 98203 <br /> PROP06EDUSEOFWILDINO Bufldinp M�dNMal MOMIon MEAT�OURCE <br /> rEMNT COmbYNtiOn PIIMnbMp WORK ANNMbn EAWk <br /> ��'�-0..�1 7YPE � DMnWidon � Sipn IYPE N�w � OM <br /> U Sprinkbr Fbp�rnA�Yil. aw <br /> CONT1tACT PRICE Of WORK � I(p U O ���T�LOCAL iALEB TAl(CODE 1�NO{ <br /> wanc oEscwPnoN <br /> �jJl� �LEc-��cR�- / rJliv.e�vs� onrq � LE-�-E2 � N�'a <br /> PLUM&NO AL <br /> N0. TYPE OF FlXTURE OR ITEM N0. TYR Of FlI(T'URE OR REM <br /> WATER CLOSET NC-MFIANDLINO UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK R DISPOSAL CLOTHES DRYER <br /> DISMWASHER _ RANOE HOOD <br /> LAUNDRY TRAY WATER MEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPUCE INSERT <br /> DRINKING FOUNTAIN tiA3 FIREPUCE <br /> _ FLOOR DRAIN OAS RANOE <br /> BACKFLOW PREVENTER l3AS PIPINCi <br /> SINK(SERVICE/BARIMOP/ETC.) FXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT i HAVE READ AND E%AMINED?Fi13 APPLICATION AND KNOW THE Si1ME TO BE TRUE AND CARRECT. ALL <br /> PROVISIONS OF UN5 AND ORIDINACES GOVERNING THIS TYPE OF VYOfiK WILL BE COMPLIED WITH WlEiMER 8PEGfIED MEREIN OR <br /> NOT. THE GRANT1NCi OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIAiE OR CANCEL TME PROVISION OF ANY OTMER <br /> STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR THE PERFCWMANCE OF CONSiltUCTION. THAT 1 AM AUTHORIIED BY 7►E <br /> OVIMER OF 7MIS PROPERTY PERFORM THE WORK FOR NMICH APPLICATION IS MI10E AND I COMPLY YNTH TT1E STATE <br /> CONTRACTqtS�t!. .700 WAC. <br /> / B-ZV- v� <br /> natu ant <br /> DEBIT�CREDIT CARDS ARE NOT ACCEPTED S�D3Q8"pd <br /> � <br />