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--- � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 96201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADORlS! . r�- l�JA PARClL TAIt l.D./ PERMR It � <br /> �qOS S�.cv�er�1 �s�' ISTA3 BO�/� Co G 3 CG <br /> LE LOTNO. BLOCK TGCT <br /> DE9C. <br /> r � �,�n„u .. 21 .E (1'S <br /> ns��y <br /> � a�., ,Ebcla f.�/a 91oS' Jtav�a�1 h�'t�l �4t}f`987�3 't 8'3f3 <br /> 7ElIANT NANE � CONTACT�OR PlRMR PNONi <br /> S�Ikl A/1 dQ.�DU�e I S�.n.I /Q Q.�Uc <br /> CON7RACTOR f� p�,Jnf/t ADDRE7S 21P cO�rtR.4CENi!{ <br /> PNONE <br /> �ROPO�lDUSEOfEUILDINO Bulklhg MeWnICOI AEtlltlon HEATSOURCE <br /> FertNR combin�tbn BPlumbin0 YV�RK AN�r.sm �IY�F]ectric <br /> A�l 7VPE py111pII1i011 LJ Slpn TYYE I:ew �.{ OM <br /> I7nA.l. � SPrinlder R¢a��nt LJ OIMr <br /> COwnucT vwce oF oRK CrtY OF EVfiRkTT LOCAL S�s 7�uc CODE li 3101 <br /> WORK� <br /> PLUMBINO MEC <br /> No. rrre oF pxruae on�., N0. TYPE OF FlIRURE OR Ral <br /> WATERCLOSE7 _, A1G-A/HANDUNOUNIT3 <br /> , BATM UB � PORCED AIR SY6TEM5 <br /> _ LAVATORY(WASHBASIN) HEATPUMP <br /> _ SFiOWER UNIT NEATERS <br /> KI7CMEN 91NK 8 DISPOSAL CLOTHES DRYER <br /> V DISHWASHER RANGE MOOD <br /> U+VNDRrTRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACFJ3TOVE <br /> _ URINAL FlREPLACEINSERT <br /> DRINKINO FOUNTAIN OAS FIREPLACE <br /> FLOOR DRAIN GnS wwOE <br /> BACKFLOW PREVENTER � OAS PIPING <br /> ` SINK(SERVICE/BAR/AAOP/ETc) _ EXHqUST FAN <br /> OiHflR _ OTHER _,_ <br /> � I HEREBY CERRIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND IQJOW THE SAME TO BE 7i2UE AND CORneCi. Au <br /> � PROVISIONS OF LAWS AN�ORIDINACES GOVERNIN6 iHl9 7YPE OF WORK WILL BE COMPLIED WfTH NMETHER SPECIFIEO MEREIN OR <br /> NOT, THE GRANTING OF A PERMR DOES NOT PRESUMETO ONE AUTMORIiV TO VIpLA7E ORCANCEL TME PROVISION OFANV 07HER <br /> STATE OR LOCAL LAW REGuwnNp CONSTRUGTION OR iHE PERFORMANCE OF CONSTRUCTION. THAT I AI.S AUTMORIZEO BV h1E <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WMICH APPLICATION IS MADE At�D I COMPLY WI7M TME 6TATE <br /> CAMRACTORS UW 1E.27 RCW AND 2YE.100 WAC. � <br /> ���nv �/�G�'�1.�'-,cf y�s//c3 <br /> S�gneture o er octonTuN � eC Ayent Date <br /> DEBIT 3 CREDIT CARDS ARE NOT ACCEpTED <br /> � 'd o"BC�' oN LEBI 896 90i (I�S HMN IYd39�8 BOOd ' Id' �ay <br />