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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 GEDAR STREET, EVERETT,WA 98201 <br /> A25-257-8810-FAX 425-257-8857-�www.evorettwa.org <br /> pppLICAT10N8 ARE ACCEPT�D FROM 6 AM TO 4 PM <br /> SITE AP�RESS PARCEL TNf I.D.M PERMIT t <br /> (B 1 sf r. E 0 OUoo �n oo '�'l�vl I - '�� <br /> LEGA LOTNO. BLOCK TAACTOHSU9DIVI510Nt <br /> DEBC. <br /> OWNER 8 CITVTP PH E ��' <br /> �Y1dA��b' �`IA�Y10.+r�i�� N�C�I�Cb �3�3 ►�* or sE Fve�+ qRao3 g�3���" <br /> 1FHANT E I CONYACTFORPERMR PM�Ne <br /> EaAAIL <br /> � <br /> (;l.�� FIJ�'�'nF_ L6G ZII�p22or+ SE . �"' �1 ma�n+lnYr.tcr�a�a. hb0�l.: K�-S-���-'1�31 <br /> cowrn.ucerue r <br /> Bwect�r q�i`�►z <br /> U9E OF BUILDINp I NEAT SOUqCE CONTRACT PRICE OF WOPK <br /> _ElecMc ,.,�QGes_Ocher ���,�� <br /> WORK DEBCRIPTON <br /> $0`�o -�u,r1�QCe. i-o ���D ''�rY�0.C� <br /> - pLUMBINQ MECHANICAL <br /> ND. 1YPE OF FlXTURE OR fTEM � NO. TY�E OF FlXiUPE Op RCM <br /> Tollet . _ A/C-e�r handlinp units <br /> � Oathtuh _ Foresd ak systems <br /> uvntory(wash hesln) � _ pan piping. <br /> W alar heater <br /> ' S17°�"'et � Gea tlropiace <br /> _ Kitchon sink 8 dlsposal — Qas ronqe <br /> Dishwasher �— Cbthes dryer <br /> � Clothes wa_ahur � qaqfle hood <br /> T WatorMater Exhauctfan <br /> � Sink(servlcelbar/mop/elc.) � Hoat pump ' <br /> � Backflow prevenror Untt heuter <br /> Urinel � polier <br /> � UrVnking Fountaln - -- pp{�garaqon <br /> � Floordrain — Woodat ve <br /> Grenco trap � �a� �Lr e/ <br /> � Root drelns <br /> Other <br /> CItY OF EVEACT7'LOGAL eALES TdX COUE IB�705 <br /> I hcreby cerBlty lhal I hevo read nnd examinod thi8 app��ation and know Ne semo ta be trUe end correM, All provlslon6 0l Iflws and <br /> ordtnacos govarnin0 th�s ryPo of work�v���be Complled with whother epccl8od hereln or not The Orantina of a petmit dons not presumc <br /> to plvo authorlty lo violate or cAncol th6 provlslon of eny olh8r 9lalo or loCal lew rogulatinp constructlon or tho poAortnance of <br /> constmctlon.Thn[I um aNhodzed by the Ownor oi tbis proporty lo pr.dortn th8 Mrork tor whiCh appllcatlon is mado end!comply wYlh tho <br /> Slnto raMors LeW .27 RGW w�d 296200 WAC. <br /> � ��• �S ' 0 v <br /> •- Iato � <br /> Signo re o O ed onirac r Authorfzod A6ent <br /> __... <br /> zooi°oo� ---- -z��__eo ,�,.�.Hoti aze�;si� it <br />