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_ oaioe�o: 1::a0 FeI _—� �ooz <br /> —�._ <br /> PERMIT APPLICATION j <br /> CI'rlf OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857 <br /> � � <br /> SITE ACDRE95 PARGEL TAX L�.f PERM�T• � <br /> � ew� Au�. �3 ��'o�� I <br /> lF(3A LOTNO. �LOCK TRACT <br /> DESC. A I <br /> OWNB ADDR PHONE/�� <br /> re�a�t?Ar�sue, �r,�I.et» 2g�,e Ld.JSY ��• `'� <br /> �is�a.tc -�,,,�-fe� 2oS. �sur�L�T`r w.4. �b261 25�1 "�lb'D , <br /> TE►I�NT NAME CONTACT W�MC P110N[ <br /> • I '�o►..� I�LaE. �1ZS) 2S�-b�eo <br /> corrrw►cron�LL ��.�,�.�.te� �ooneaa aP coHrR.ueaaa+� <br /> �,a.vycr� �Nc . 154as �'r� s�t: T� <br /> PMONR � ,�,.�w�� ,,,,�►. 9S� P��cc6 ��.r <br /> �}2y S - � <br /> PROPO!!D USE OF 9UILOINa BWldirg MYChYdCal AtlWtbn ME�TlOURCE j <br /> (Z.T�cl4►10►JA���'�(M� ��'rT ��inedon B Plumbinp WORK Alw�Nm El�ctrlc I <br /> l�v�JTS LE►�'T�rJe- rrra gp�mron F�sl9n rne � n�urn.w�c �on� <br /> CONTAACi 7RICQ OP WORK ' CT/OPlV01[IT LOCAL�AlalTA7[COOE IB 3106 <br /> WOIIK DESCRIP'i10N <br /> ��b�G'R-�'T'� �1�1�XrtS � '�����TID1��S 'p�+-s� <br /> ST,2�e.Tv�� vn,aw� n�e�s 'L.r�,a-r� 4�8102'� �.ti r� <br /> S�s�rn, t}E� I�'Y 51aM�rlr� .e.su'Fovw�r�aYio►.� �-.W+,T Sur���tt+'il�� <br /> PLUMBI N MECHANICAL <br /> NO. TYPE OF FIXTURE OR RJA NO. TYPE OF RATURE OR ITEIN <br /> WATERCLOSET � A/C-A/HANOLINOUNITS <br /> � BATHTUB , FORCm AIR SY9TEM5 <br /> _ LAVATORY(WASH BASIN) � HEAT PUMP <br /> _ SHOWER _ UNITHEATERS <br /> KITCHEN SINK 8 OISPOSA: _ CIOTHES DRYER <br /> _ DISHWASHER � RAt�E HOOD <br /> _ LAUNDRY TPAY _,_,. WATER HEATER <br /> _ CLOTHESWASHER �, MEfALFIREPLACE/STOVE <br /> � URINAL _ FIREPLACE INSERT <br /> _ DRINKING FOUN7AIN OAS FlAEPUCE <br /> FLOOR�RAIN _ OAS RANOE <br /> _ BACKFI.OW PREVENTER _ OA6 PIPING � <br /> SINK(SERVICE/BAFVMOPAEl'C.) � D(HAUST FAN <br /> _ OTHER , _ p7}�Ep ; <br /> � <br /> — — � <br /> I HEREBY C�RITIFY THAT I HAVE RE4D AND pUMINED TH19 APPLICATON ANO KNOW T1E SAME TD BE TRUE ANO CORRECT, ALL <br /> PROVISIONS OF tAWS ANp ORIDINf CES 60VERNIN(3 THIS TYPE OF WORK WILLlE COMPLIED WITH NMETHER SPBCIFlED HER�N OR <br /> NOT. THE GRaNTING OF A PEAMIT I)OES NOT PRESUME TO�IVE AllTHORfTY TO VIOLATE OFi CANC0.THE PROVISION OF ANY OTHEH <br /> STATH OR LOCAL UW REGULATING CdJSTRUCTION Oq THE PERFONMANCE OF CONSTRUCTION. TNAT I AM AUTNOAIZEO SY THE <br /> OWNEA OF THIS PROP6RTY TO PEF FOHM TFiE WORK FOR WHICH APPUCATION IS MADE AND I COMPLY WrtH THE$TATE <br /> CONTRAC 5 V1W 18.27 RCW A II 2W W <br /> �1. �/� �'�/02 <br /> 5 elure o Owner ont od u �o zpd gant ��— <br /> rz <br />