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01248 P.004/006 <br />11/27/2072 21:49 <br />SITE ADDftESS <br />zaa'� � <br />�eGq l-OT NO. <br />►J <br />NAME <br />J <br />PERIVIIT APPLIC�/�TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evefettwa.org <br />APPL.ICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEI. TAIC I.D. iM <br />� i <br />7 <br />8l.ocK TRACT OR SUBDIVISION p�� - <br />i <br />G /✓ 1� �H / . <br />POR PERMIT . <br />PMONE <br />� �- _ _ _ _ AQDRE55 " i � . •••�••�•• � <br />OR <br />�"�/a� �r %�YS %� .S"r'`"```. _. .. 36'O/ ���'�� .. , - <br />coH R uCe�v%..4N'SSDcf ZI�Z <br />USE OF 6111LPING <br />�P S <br />NFAT SOURCE . <br />' _ _ �lecVic � Gas _ Other <br />WORK DESCRIP710N � � . . <br />N0. <br />�j'dn v /��� QOu� 7� <br />�lv'(i� ��•:-G�/u jLiv.-�. <br />PLUMBING �— <br />; <br />1YPE OF FIXTURE OR ITEh7. .—�'---=.- . <br />Toilei <br />� Bathtuli <br />� Lavalo�y (wash basin) <br />^ Shower <br />Kitchen �ink 8 disposal <br />Dishwasher <br />Clo�hes washar <br />Water heater <br />Sink (service/har/moplotc•) <br />_ Backflnw preve�ter <br />Urinal <br />Drinking Fountain <br />Fluor drain <br />Grease Irnp <br />Roof drains <br />Other <br />PERMIT q <br />yz� .- asA � �6/ <br />CONTRACT PRICE vt wunn <br />3�600 �- <br />. . �>Yh O/ "{� <br />;.,... .. �..�...... <br />_. �' <br />... TYPE OF FIxTURE oR IisM <br />A1C — alr handling units <br />Porcod alr sysloms <br />Gas piplrip <br />Water hoater <br />Gas fireplace � <br />Ga5 rongo <br />Clothr,s dryer <br />Range hood • <br />Exhaust 1an " <br />Heat pump <br />Unit Aeater • <br />BOiler <br />Refriperatlon <br />woodsave <br />Othor <br />C17Y OF EVERETT LOCAL BALES TAX GODE lS 3105 _ <br />1 horoby ceritify thal I have read and e�wmined this applica4on and know the same tn be Vue and co�rect. All provlslons of laws and <br />ordinaces goveming this typo of work win oe compliod with whalher specified harein or not. The pranling o( a permit does nol presumo <br />to give aulhority to violate o� cancel tho provision of any other state or bcal law �e9ulating constructlon ot the pertomianca ot <br />construction. That I am auttiorized by the owner of this propeAy to parform the work tor which applicaUon Is made and I comply with the <br />Scate Contrect� Law 18.2� RCW and 29s,20d�NAG_..: � <br />. . �.:,,-,:—.. . <br />�, , .,.�. <br />