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� <br /> NERMIT APPLICATIuN <br /> CITY OF EVERETT PERMIT 3ERVICES <br /> 3200 CEDAR S7REET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—;Nww.everettwa.org <br /> APPLICA710NS ARE ACCEPTED FROM B AM TO 4 PM <br /> SIT!ADDRE56 PARCEL TAX I.D.R PERNIT 7R <br /> I'-�Ol �Gt�X- 000cLa�loo ri1o6ol�oa5 <br /> lE LOTNO.� BLOCK TRACT � <br /> DESC. <br /> OWNER ADDRESS I P PMONE U25'r, <br /> F F. ���A�n�ur- L,� 19yof 40�� w. � a.8� W�.°��v c�o-q�4�. <br /> TfiNANT NAME CON'I'ACY FON PERMIT PNONE <br /> FF. o�.�o�m�Nr L, P P�►J �i�vAU �+zs- 3�e -o-tm <br /> cormtncra�. �+�ITRoru L.��C- nooness g�Zo S cirv¢ir iMONE <br /> TNiST�-@. S�� 2r�•7LS-�3toQ� <br /> CONTR.�JCENS�# t L.A�,�L 71� lJ��.JNN ����WA' I <br /> V IL O�811 g t13� <br /> U9E OF BUILDING I MEAT SOURCE I CONTRACT PRICE OF WORK <br /> �All.�'l�q�l v Eiectric _Gas�Other 1� 1 O`'� •3q <br /> WORK DESCRIPTION <br /> V�IJTIh1(� N�IrJ C�ubt'1tut.,'—toi,1 1Y11,u�'rlF�l,iu-f <br /> PLUMBIN MEC ANICA <br /> N0. TYpE OF FIXNR[OR 17EM NO. TYP6 OF FIMURE OR fTEM <br /> � Taiiet WC—eir handling units <br /> _ Bathtub ' porcedairsystems <br /> _ Lavatory(wash basin) + Gas piping <br /> Shov+�� Water healer <br /> _ Kitchen sink&disposal i Gas fireplace <br /> , Diahwashor Gas ranga <br /> _ C�otbes woeher 7S Cbthes dryer <br /> _ Watorheater �� RanyeMod . <br /> � Slnk(serWce/b�r/mopletc.) Exhausttan <br /> _ Backflow prevenler _ Heat pump <br /> __ Urinal ' �Z Unit hcate� <br /> Orinking Fountein galler <br /> _ Floordretn � Refrigeration � <br /> r Groesetrap Woadstave <br /> � Roofdrains � Other <br /> Ofhor <br /> CITY 0�EVERE7T LOOqL SALB9 TAX CODE IS 3105 <br /> i horepy eedtity that I have reatl entl examined thls appFcaUOn and know the same to be hue and correct. All provictona ot I�we and <br /> ortlineeee yoveming this type ot work wlil be complied with whotMr spaeifiod heroln or not.The prantinp of e permlt tlopb not prCeume <br /> to phro euihor� to vlolate or�ancel the provkfon of 2ny other stafe or local law regulatlng construcl(on or tM performance o1 <br /> co�atruelion at I am a ed by the owncr of this p�porty 10 pe�{o�me��for which epp(ication fe made end I cnmply with th¢ <br /> 9tate Co� fs Lew 1 CW and 298.2D0 WAC. � <br /> a— ` - - / (O p � <br /> Sipn e �r on Clor AUthonze Apont ete <br /> �� <br /> O' V <br /> ,r �lD <br />