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�� L07 NO. <br />DESC. <br />OWNER <br />�ONn �,�y <br />TEN/W7— N/V� <br />coNrRn � ;. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEC.qR STREET, EVERETT, Wq 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�� <br />PHONE n�/ �f O Z"Y7�J� <br />�,��e- � <br />PR <br />–���. �oc u� euI�DING <br />CONTRACT PRICE OF WORlC` <br />W/��✓ <br />� ,,ornRCEI TN( I.D. �t <br />L � <br />TRACT ---�� <br />y�_.=h �4v�- <br />CONiACT FOq pE��jT '— <br />C.i'li1G�/C�' L�Xc.li4' <br />� <br />�DO `�'ljery� <br />��Ce C�/.� <br />PERMR Buildinp Mechanicel <br />Combinatbn �p�umbing <br />T�TE Demolition �B� <br />Sprinkler <br />..�arnm I IVry - <br />�i�PCOi�/i L i� ��1' <br />NO. I TYpE OF FIXTURE OR ITEM <br />. WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WqSH BASIN) <br />SHOWER <br />KITCHEN SINK 6 UISPOSqL <br />DISHWASHER <br />LAUNDRYTRqY <br />CLOTFiES WASHER <br />URINAI <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBqR/MOPlETC.) <br />OTHER <br />3 �ar-��s-- <br />��L�'JZG'o �&'z y7c� <br />'�(�Z�P CONTR, LICENSE / <br />�'1�., 4/�f/�.f %R�C�f <br />�Addtlon <br />Nteratlpi <br />ew <br />R�pair/Maint. <br />HEATSOURCE <br />�Electrle <br />Gas <br />Olher <br />CITY OF EVERETTLOCq� SALES TAX COpE �g �105 <br />�U/'l74!'�e �/'1/�1��4 s-�� <br />NO.. I TVPi OF FUCTURE OR ITEM <br />FORCED AIR SYS7EMS v <br />HEAT PUMP <br />UNIT HEq7ERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREf �ACE/STOVE <br />FIREPLqCE INSERT <br />GAS FIREPLACE <br />GAS R/WGE <br />GAS PIpING <br />EXHAUSTFAN <br />OTHER <br />1 HEREBY CERITIFY 7}�,qT ��qy� READ AND EXAMINED THIS APp��CATION AND KNOW TME SAME 70 BE TRUE AND CORREC7, k� <br />NOTOV7HE GRqN NG O�A ERIMIT OOES NOT RFESUMEITO GIP E�AUTIH�ORITY TO VIOt,Ai'E OR CANCEL TME PROVISION OF qNy OTHER <br />STATE OR LOCAL lAW REGULqTING CONS7RUCTION OR THE PERFORMqNCE OF CONSTRUICppry+ .� �� A��CIFIED NEREIN OR <br />OWNER OF T}��S PROPeRTY TO PERFORM 7HE WORK FOR WMICM APpL�Cq7�ON IS MqpE ANp � COMo <br />COQNTRACTO IAW tg_y7 RCyy q�D 29g.20D Wq�. TMORI2ED BY 1'}¢ <br />�fV._.I_�✓L. _ ,.1I.,-'�.. --/ / LYWIT'MTHESTATE <br />DEBIT & GREDIT CARDS ARE NOT qCCEMTEO <br />i'd LSBBL5252hI:�_. <br />�woa� r�:st seez-ez-�nr <br />