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91TE ADDpESS <br />LOT NO. <br />DESC. <br />P��MIT APPLICATIG'�.� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-88'� 0 — FAX 425-257-8857 <br />oLOCK <br />�GFFw.ay P1�4«�. L�c. <br />TENANTNAME <br />�oHTRACTOp G E'�STS[� <br />PHONE <br />PROPOSED USE OF SUILqNa <br />CONTRACT PRICE OF WORK <br />PARCEL TAX I.D. • <br />a 3'�3z -�, -02 �- o0 <br />TRACT' <br />2 <br />^�.:..L <br />��, ADDRESS <br />/Y�9 .�vt'• <br />/�i'f/S� Sa7 <br />o -�►s so7- � <br />0 <br />PERMR M <br />PNONE <br />-s,�., c ���ass--2 se <br />aP qONTA. Ll(�WSE I <br />o. G'�'rsc� zGy � <br />�Z1o���S�l- 5$ t g c� <br />��ii Building hAachanical <br />PERAMT � Combinetbn � Plumbing <br />TYPE Dehwliqon Sipn <br />Sprinkier <br />�1ddiUon I MEI1T EOUlICE <br />NlMtfon Ebctrie <br />N�w Oas <br />RpddM�Ml OIMr <br />CITY OF EVERETT LOCAL fALES TAIf CODE Is �106 <br />WORK DESCPoPTION <br />�L�MU �'XIS%/4� �ovSte� �¢y0 <br />��,D C.�t-�G�= d- sF��� <br />NO. I TYPE OF FlXTURE OR ITEM <br />WATER CIOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAI. <br />DISHWASHER <br />LAUNOP.Y TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PfiEVENTER <br />SINK (SERVICFJBAR/MOP/ETC.) <br />OTHER <br />�• I nPE OF R%TURE OR REM <br />wc -,vr+nrvouna urvirs <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANCiE HOOD <br />WATEFl HEATER <br />METAL FIREPLACFISTOVE <br />FIREPLACE INSERT <br />OAS FIREPLACE <br />OAS RANOE <br />OAS PIPINO <br />EXHAUSTFAN <br />OTHER <br />I MEREBY CERITIFY THAT I HAVE READ AND EXAMINED TMIS APPUCATION AND KNOW TME SAI� TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIOINACES dOVERNIN6 THIS TYPE OF WORK WILL BE COMPUED WITH WHETIER SPECIFlED HEREIN OH <br />NOT. TME GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE AUT}iORITV TO VIOUTE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR IOCAL UW REGUTATING CONSTRUCTON Oq THE PERFORMANCE OF CONSTRUCTION. iHAT 1 AM AUTHORIZEp BY THE <br />OWNERpFT915Y�ROPERTY TAPERFORM TNE WORK FOR WHICM APPUCATION IS MAOE AND I COMPLY WITH THE STATE <br />COy�RACTOR�1yi iaz�gcyr nNq zse.2oo wnc. <br />