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71..��1303-3'� <br /> C'ERMIT APPLICA��N <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STHEET, EVEFIFTT, WA 982U1 �,�) J -�� _ ��� <br /> 425-257-88�0 - FAX 425-257•8857 � � <br /> l�� "7 C'o3n/ - 003 <br /> SITE ADDRESS PARCEL TAX I.D.N PEarnii r <br /> 4: xx I� �= Sr. SC /1rr- z��r 192So5- _p��_q� <br /> LEGA LOiNO. BIOCK � TRACT <br /> oesc. Z — Saart�5u p,✓� io,.l o, f Z�b i'..-R- O/ <br /> OWNER ADDRESS ZIC PHONE <br /> y}z? Lp�.�w�o2n. 3c.o•-ldS2 -/q-?S <br /> L-11'C Sry�C �amSs�C�osasT,i-�NL. .577�.�w o-e t�� WA �$Z9Z � <br /> TENAN7 NAM CONTACT NAME PMUN� <br /> I �w. Wndr��s �12S-�s�F-1 <br /> Tw� �_,fn�r (SrTE� �/2S•-�S�_ l3`13 <br /> CONTRACTOR ADDHESS ZIP CONTR.LICENSE/ <br /> c��-�Yy� N�,�,� ���:,�� . wz� �.r��x,� �. lJF� SHC�SY`(ItT <br /> PHONE S7ANWOoO WA 7BZ�JZ <br /> 3�� - ! - - , <br /> PROPOSED U9E OF BUIIAINa Building 1� Mechanical Addmon MEAT SCURCE <br /> PEFN.R Combinetion H PlumSing WORK RI..1 Aueration �[� Elxtrw <br /> riPE Demolitfon LJ Sign 1YPE :�y Naw �¢�es <br /> ��'(� Sprinkier U RepeiqMeint. U Olher <br /> I CONTRACT PRICE OF WORN / CITY OF EVERETT LOCAL 8ALE9 TA%CODE 19 3106 <br /> *�5��13� ..�/+� <br /> WORkDE9CRIPTION - � —� �� ,� �X� <br /> f= «��. -� .�� � � <br /> Il�I� 5:-1? Ce�,��rra��c•;�o�.1 l��c{ <br /> 1 <br /> ', PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR REM NU. TYPE OF flIRURE OR REM <br /> I WATER CLOSET .� q/C -NHANDUN6 UNITS <br /> � � BATHTUB �_ FORCED AIR SVSTEMS <br /> � 3_ LAVATORY (WASH BASIN) y_ HEAT PUMP <br /> y SHOWER y UNIT HEATE�S <br /> �_ KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> 1_ DISNWASHER _/_ RANGE HCOD <br /> � IAUNDRV TRAY � WATER HEATER <br /> _f._ CLOTHESWASHER � METALFIPEPLACE/STOVE <br /> � URINAL � FIREPLACEINSERT � <br /> � \ DRINKING FOUNTAIN <br /> 9AS FIREPIACE � <br /> I S FLOOR DRAIN GAS RP.NCiE <br /> � 6ACKFLOW PFEVENTER �1 GAS PIPINO <br /> �. SINK (SERVICE/BAR/MOP,'ETCJ 7 EXHAUST fAN <br /> �. OTHEH 1 OTHER_ <br /> I HEREBY CERITIFV 'HAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNO'N THE SAME TO 9E TRUE ANO CORRECT. ALL <br /> PROVISIONS�JF LAWS AND ORIDINACES GOVERNING iHIS TYPE OF WORN\NILL BE(::1MPl1E�WITH WHF.THEF SPECIFIEO HEHEIN OR <br /> NOT THE GR4NTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY i0 VIOUTE OF CAhCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW qEGULATING CJNSTHUCTION OR THE PERFOPMANCE OF CONSTRUCTION THAT I AM AUTHORiZED BV THE <br /> OWNER OF THIS PROPEP'Y i0 PERFORM THE WORN FOR WHICH APPUCATION IS MwDE ANU I COMPLY WITH TME STATE <br /> CONTRACiORS LAW 1 27 D 29620 � <br /> _ � <br /> �l' '��Z <br /> Signe wner/ onlrec or uthonzed Agenl ele <br /> `� ` . .. ! `/ I/.1. <br />