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P�RMIT APPLICATI(�N <br /> � CITY OF EVERETT PERMIT SERVICES <br /> �"" 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810- FAX 425-257-8857 <br /> S�TE ADDFiESS I PARCEL TAX I.D.k ' PEAMIT xG',�9-OI� <br /> 'v�zo S` / ,e.vF .S� <br /> LEGA LOT N0. SP BLOCK TAACT / r � / <br /> DESC. 3 /202•CaG�• Iv[� ��4 oG � �lJr.'G .Z�j7�Ji�ZQN �4 �� CJ/�l <br /> OWNER ADDRESS Z1P �PFIONE � <br /> ��i � � � ��a,9 j ) <br /> /`7it:/�� H//1R�i �^/Jo ��r�-' 30� / uv�c� �'oc �vS- �5//3 <br /> � <br /> TENANTNAME I CONTACTNAME PNONE <br /> CONTRACTOR � ADDRESS � LP CONTR.LICENSE N <br /> �t✓L /C��AF ��.vST.� /n.G %�'��S1!J'o2 /._J�/dAL(,� �O/9 �C c/E2C1'9�(o T 7' <br /> PHONE <br /> �2�c,) FiiS • '�yi3 <br /> PROPOSED USE OF BUILDING pERMIT I� Sprinkllea�ion � Pl9mb ngal W�RK � Repa 1 MeinL HEAT SE eRCE <br /> o.�/�/6CF //fH/C-y� TYPE �.{ DemJlilion Si n TYPE New � Gas <br /> �� Li U Other <br /> CONTtiACT PRICE OF WORK �' G'�L�„ CRY OF EVEHETT LOCAL SALES TA%COOE IS 3105 <br /> O <br /> WORK UESCRIPTION � ( <br /> /t�CcJ G✓ao� �,2a.-��) �sG i�JflS/G � aZv.3� <br /> PLUM8ING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI7(TUHE OR ITEM <br /> � WATERCLOSET A/C-A/HANDLINGUNITS <br /> � BATHTUB � FORCED AIR SYSI'EMS <br /> -'� LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> � KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> � DISHWASHEA � RANGE HOOD <br /> LAUNDRY TRAY / WATEfi HEATE� <br /> _L CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN �- GAS FIREPLACE <br /> FLOOR DRAIN 'T�at- GAS RANGE <br /> _ EiACKfLOW PREVENTER �1� GAS PIPING <br /> SINK�S[RVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> �HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNO�V THE SAME TO BE TRUE AND CORRECT. P.LL <br /> PROVISIONS OF U1WS AND ORIOINACES GOVERNING THIS NPE OF W�1RK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAN NG OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO\'IOLATE OR CANCEL THE PFOVISION OF ANY OTHER <br /> STATE OR LOCAL REGULATING CONSTRUCTION UR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PR ERTY TO PERFORM E WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOPS LA 1827 RCI�ANJj296.•�AC. <br /> �� � /l <br /> C C. I`/ ` <br /> SignaWre ol OwnedConlraclodAuthorized Agent Date <br /> 1�Z <br />