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( <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER;�'TT, WA 98201 <br /> 425-257-8810—FAX 425•257-8857 <br /> SITE ADDRE S PARCEL TAI(I.D.� PERMIT• <br /> lalq - a� 3 i ��s�o��/oo l -oa <br /> LEOA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS � LP PMONE <br /> �Ec.uET �llEu �I�.rO��, 1 oI c�-mR►2«)EVI�J .I�.�&2�s 4zs$�ov637 <br /> TENAHTNAME CONTACTNAME PF10NE <br /> T�c���S A,�n�u� I � �.K� 42s��� �r�� <br /> CONTRACTOR aODRESS nP CONTII.LICEN6E� <br /> PHON�� <br /> �' M E��'OF�� TYPE� Deimolit9ionon Slumbi�ng I �E R ��L �T[ yU� <br /> � j <br /> �u i � f-t .� n <br /> SprinWer �Repe C� <br /> CONTRACT PRICE OF WORK P. �O�d UQ^ CITY OF EVERETT LOCAL SALE8 TAX CODE Ib�106 <br /> �WORK DESCRIPTION <br /> ���� �` <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FlXTURE OR ITEM NO. TYPE Of Fll(TURE OR RFM <br /> WATERCLOSET _ A/C—NHANDLINf3UNITS <br /> _ BATHTUB _ FURCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> _ SHOWER _ UNITHEATERS <br /> _ KITCHEN SINK d DISPOSAL _ CIOTHES DRYER <br /> _ DISHWASHER _ RANQE HOOD <br /> _ LAUNDRY TRAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN _ OAS FIREPLACE <br /> _ FLOOR DRAIN _ OAS RANOE <br /> _ BACKFLOW PREVENTER _ (3AS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND E%AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND OR�DINACES GOVERNINa THIS 7YPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO QIVE AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANY OTHER <br /> STATE OR LOCAL lAW REGUL4T1N6 CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THA7 I AM AUTNORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE 3TATE <br /> �CONT ACTORS LAW,�18p.27 RCW A D 298200 WAC. <br /> CP�l�ef_1'L `Cu ��{/1iC 2� (J 2 <br /> nature o wner! ontracloN ut onzed yent ete ^ <br /> /'� <br />