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NPR-3-20C?6 07:?6 FROM:PE�TIIT q257756315 T0:14252578857 P.1 <br /> PCRMlT APPLICATIO�v <br /> CITY OF EVERETT PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �703 Vl�Ta�- P/ pos53 /m/o27aU YVID�o�I-�( <br /> LEG LOTkO. BLOC�( TRACT <br /> DESC. <br /> OWNER AD�RESS ZIP PHONE <br /> 1< (r.f�' �-, O� h z�o3 t/tc�P� �'�zoi �Z.r�sz.�9�� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �Lvu-Q- I ,(�ild� yzs 273- s�i5� <br /> CONTiiAC70R � � AODRESS ZIP CUN7R.LICENSE p <br /> wHJ'+a �-�w��r� �tr1C�J <br /> PHO��O �L y7QJ CitJ�7/ //��TY'C-�� E) l�/�`s�i�J9�i q3 <br /> ' '�ic �/9T <br /> PROPOSED USE OF BUILDIN(i Builtling Mechanical AOtlition MEAT SOVftCE <br /> � PERMI7 RI-1 Combinafwn Plumbin�j WORK Allcrallon nl.-L,ElaGrlc <br /> � �' TYPE (.,) OCm01iti0n Sign ttPE �New .�Q Gas <br /> lJ Sprinkler � RepainMalnl. L] Other <br /> LO�fAACT PRICE OF WORK ��� — CITY OF EVERETT IOCAL SALES 7AX COD615 3705 <br /> WORN DESCRIPTION <br /> Gr+s c.��.�,- G��,�- �y14�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE UR ITEM NO. TYPE OF FIXTURE OR ITEh1 <br /> WATER CLOSET(fOiLET) � A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER � RANGE NOOD <br /> _ LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER G�5 PIPING <br /> SIVK(SERVICF/BAR/h10P/ETC.) � EXHAUST FAN <br /> OTIiER OTHER <br /> I HcREBY CERITIFY THAT I HAVE READ AND E!WNINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PFOVISIONS OF LAWS AIJD ORIDiNnCES GO`�ERNiNG THIS TYPE OF WORK WILL BE C01dPUED WITH WHETHER SPECIFIE[1 MEREIIJ OR <br /> N07. THE GfiANTING OF A PER�,1iT OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STAIt OR LOCAL LAW REGULATING CONSTRUGiION OR TF1E PERFORAtANCE OF CONSTRUCTION. THAT I AM AU7HORI<'ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHI H APPI.ICATION IS h1ADE AND I COMPCf WITH THE STATE <br /> CONT CTORS LA 27 RCW AND 296 20°� (J / <br /> �l�t ��Yt 4-Lc( U � 3( �� <br /> � Si at re of Owner/ConiraclodA i nzed Agenl Dale <br /> ` DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />