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l � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-25T-8B57 <br /> SITE ADDRESS PARCEL TAX I.D.M PERMii• <br /> � 223 2�c�� f�v.e. eio zZ uo�c� Mos �z -ao3 <br /> LEGA LOTNO. BLOCK TRACT <br /> DE6C. <br /> OWN ADD N 'L� <br /> S' 11,t t l y D 'gr ��r� lZ2 3 f'2Uc�d*� 9�2�I 2�?s7� <br /> TENANTN�ye CONTACTFORrERM1T / - rMGME <br /> I L.f(� � �I.�G LGQl a0�0 V 1 � <br /> ���TpR_/�� L_ U f ADORESS �� 21P CONTRLICENiE/ <br /> ..r�JT; 7��n �{ <br /> (C fl �t �� 7 � GU/T✓r(�J 7 7l <br /> � z 2 'Zvd <br /> pRO�pSEDUEEOflUIlDIN6 I I� Bulldinp [[["""���MachanirJl f� MEitlon MEATfOURCE <br /> PEIIMIT ��1 Combinatbn �PlumDfnp WORK ��S NMnbn []EbUtic <br /> 7YPE K Demolitlon Sipn ME t�j��w �'Gu <br /> V Sprinkler �R�pa�aint. D onnr <br /> CONTRACT PR10E Of WOItK � �}Q � � CITV OF EVERETT LOCALlALE!TAII CODE IS]105 <br /> WORK OESCIWTION <br /> � <br /> c��{S � �'`-S C���R� <br /> � <br /> PLUMBING HANICAL <br /> �1p, TYPf OF FIXTURE OR ITEM NO. TYPE OF FlXTURE OR REM <br /> WATER CLOSEf(TOILET) _ A!C—AMANDLING UNITS <br /> BATHTUB _ FORCED P.IR SYSTEMS <br /> LAVA'ORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNITMEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> OISHWASHER RANGE HOOD <br /> IAUNDRYTRAV <br /> WATER HEATER <br /> CLOTHES WASHER ,_ METAL FIREPLACEISTOVE <br /> URINAL _ FIREPIACE INSER7 <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR D(3AIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ DAS PIPING <br /> 51NK(SERVICE/BARlMOPIETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I MEREBY CERITIFY TNAT I HAVE READ AND'eW.MINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. All <br /> PHOVISi0N5 OF LAWS ANO ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITM WHETHER SPECIFIED MEREIN OR <br /> NO7. THE ORANTINO OF A PERMIT DOES NOT�RESUME TO OIVE AUTMORITY TO VIOUTE OR CANCEL THE PROVIBION OF ANV O7HER <br /> STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORM4NCE OF CON37RL1CTION. THAT I AM AUTHORIZED BY TME <br /> OWNER OF THIS PROPERTY TO PERFORM TF'E WORK FOR WHICH MPLICATION IS MADE ANU I COMPLY W ITN TME STATE <br /> CONTRACT S LAN�1827 AND 296.20C WAC. <br /> �r,u�4���, ��rg � �Q3 <br /> Sign e o rl onUaclorlAulhonzeG Ag ale <br /> DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br /> T'd L'�3LS?Scbi�01 �bA�Jj 02°L0 £002-2-730 <br />