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LE LOT NO. <br />DESC. <br />�rb4� X oer� <br />TlNANTNAME <br />`w'"��I` �►+��y <br />�� �..5'z- � <br />pROMSED USE OF 6UILOtNG <br />r <br />C� <br />PERMIT APPLICATION <br />CITY OF EVEt'�ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425�257-8810 — FAX 425-257-8857 <br />Pn,nce� r�x i.o. r <br />) ,Qu� 00��3 2 �� <br />e�ocK rn�cr <br />/ <br />—.. ADDRESf <br />�o�, `l�b�xd <br />?OU <br />�t'�� t 9 <br />�� <br />BuAdinp � <br />PERMR COrtibMaMOn <br />TYPE OMnoNtlOn �0� <br />$pfN1ItIH <br />CONTRACT PRICE OF WORK � � <br />e <br />WORK DE3C1tiT10N� <br />I W <br />{z-���i�� C.?�' �' GQl' <br />NO. I TYPE OF FU(TLRE OIl REM <br />WATER CLOSET (rOILE'� <br />— BAT1iTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BAqffLOW PREVENTER <br />SINK (SERVICEIBAR/MOPIETC.) <br />OTHER <br />NO. <br />� <br />o � `E'2-r 2sz 3a'Ga <br />� <br />2��28�-5� <br />L► CONTR. LICEMlE � <br />cc�,l�H/E'f97/GS <br />AdOMlon XlATfOIIRCE <br />( AlMration �Q ENeYk <br />Fbw �Pl We <br />RpYryM��, C� Otlw <br />cmr oF �nErr �oca a,ties rNc eooe �e »os <br />.� <br />vey(�Ce, <br />70,C�10 �C � <br />ME OF fIXTUll6 OR RiY <br />qIC-A/M�WpLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNR MEATERS <br />CLOTHES DRYER <br />R/W(iE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GI1S R/1PIOE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I MEREBY CERITFY TY1AT 1 HAVE READ AND EXAMINED THIS APPUCATIOP� MID K►�� � 5'�'� TO BE 1RUE AND CORREC'f• ALL <br />PfiOVISIONS OF UWS AND ORIDINACES GO`/ERNING THIS TYPE OF WORK WILL BE COMPLIED WI?M WMETMBR 9PECIFIEO FIEREMI OR <br />NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHOIUTY TO VIOIATE dt CANCi� 7Mi PROV�BpN OF AN� �TMER <br />STATE OR LOCAL LAW REGUUTING CONSTR�GTION O.Z THE PERFORMANCE OF CONgTRUCTION. 7TUT 1 AM AUTMORIgD BY TXE <br />OW NER OF TMIS PROEERTY TO PERFOKM i HE WORK FOR WMICH APPLIGTION IS IMDE ANG 1 COMVLY W�TH TME STATE <br />rnura�rrcnas uY✓te�7 RCW AND 296.� �YAC. � 1/ /.,� <br />20 32�� DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br />b'd LS8815252bi-01 �bAtlj 6E�80 £0B2-6T-J30 <br />