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JRN-18-02 WED 12�58 PM VERETT PERMIT SERVICES FAR N0, 5 257 8857 P, C2 <br /> - PERIIIIIT APPLICATION <br /> �1j��,,. CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STRE�f, EVEflETf, WA 98201, A25-257-8810 <br /> SI7E A�oRESS ���Z-C� PARCEL TAX I.D.Y PEFMI7 N <br /> � - i <br /> lc i�,7 io"�'�r sc ����Nu.0 co��zsoo�o z2oo (�,:� -.3 , <br /> LE�AL L07N0. BLOCK TRACT <br /> DESC. <br /> OYJNER . AODAESS PHONE <br /> �•-�k11}�c7N � \ON�L"RD � �,�-�� ���2, ��E.S� �/7�'`�'' NoSI <br /> TENANT h A�dC CONTACT NAh1E PHONE <br /> P�,� � �� [�2S -SS��--�5$rF� <br /> � � ��� �� � CONTR.LICEN9E Y <br /> CONTRACTOR ��; !`�`,i,;nr� ;ClAI C �jfU �e%��SS1�P <br /> �f2 � ' .:':d�=;: _ I 'iithS t� 43 <br /> PHONEyZ�•,..SY�S'' � , � ��`. W <br /> pAOPGSEO USE UF 9UIL.�ING 6yllding Mechanical nAtlditlon NEAT SOURC� <br /> PERMIT R Combinallon�Plumbing WOAK D atara�wn g Elecub <br /> TYpE �emolilfon Slgn TYPe D New U Gae <br /> B Sprinkimr i� Repnir/Mainl U OU1at <br /> CONTRAC7 PRICE OF WORK J� �� CITY OF EVEAEfI'LOCAL 6AL�S TAX CODE IS 1105 <br /> WORK DESCRIPTION � ' �✓ /�C��ICI C(= C��e'i��/C �C�2 f�( ��¢ f-�l <br /> I L��74Lc"L`-C <br /> ��M�p �ECHANICAL <br /> N0. TYPE OF FIX(URE OR REh7 N0. TYPE OF FlXTURE Oii fl�:' _. <br /> _ WA7�RCLOSE7 . � •NC-A/HANDLINGUNITS <br /> BATI ITUEI � FORCED fUR SY9T°M9 <br /> LAVATOfiY(WASH BASIN) _ HEAT PUMP <br /> ^ SHOWER °' _ UNIT HEO.TER3 <br /> KITCHEN SINK&DISPOSAL _ CLOTHE6 DRYER <br /> � �ISHWASHER RANGE HOOD • <br /> ,^ IAUNDRY TRRY WAl':R HEATER <br /> ,,,� CLOTHES WASHER '' METAL riAEpl11CBlSTOVfl . <br /> � URINAL ____ FIREPLACE IN6ER7 <br /> _ DRINI<ING FOUNTAIN GAS FIREPLACE <br /> _ FLOOR DfIAIN _ GAS RANGE ' _ <br /> ^ BACKFLOW PREVENTER � GAS PIPINO - <br /> ,_ SI�K(SERVICE/f�AWMOPlE'iC.) EXHAU9T FAN <br /> '�,_ OT11ER _,.,...__��. _ OTHER <br /> � .�.::--,_ � 3�� _. <br /> I HEFFBV CERITIf•Y THAT I HAVE FFAO pND EXAA7INED THIS MPLICA710N AND KNOW THE S.1ME 70 BE TRUE AND CORiiEQT. AI.L <br /> PROVISIONS OF IAWS AND Ofl1DINACES pOV�flNIN�THIS TYPE OF WOHK WILL BE COMPLIED WITH WHETHER 6PECIFIED HEREIN OR <br /> NOT. iHE GRANTING OF A PER0.11T qpES NOT PRESl1MEi0 GIVE AUTHORIiY70 VIOlATE OR CANCELTHE PROVISION OF ANY OTHER <br /> STATB OR LOCAL L4W REGUL4TIN6 CONSTftUCTION OR 7HE PERFORh1ANCE0F CONSTRUCTION. THAT i AIA AU7HORRED 61'THE <br /> OWNEH OFTNIS PIIOf'ERTY TO PERFORh1THE WORK FOR WHI:H MPLICATiON IS MAOE AND I COMPLY WITH THE 6TATE <br /> CONTRACTORS LAW 1927 RCW AND 2 6.200 W/�0. � <br /> �, ,� � � �� Q � <br /> Slgnaturo 61 OwnerlC at ct r uthorizo penl pa�o <br />