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� <br /> P RMIT APPLICATI N <br /> � CITY OF EVERETT PERMIT SERVICES � , <br /> �"'' 3200 CEDAR STREET, EVERETT, WA 98201 <br /> "425-257-8810-FAX 425-257-8857 _. <br /> ! 1�� RESS ,� c `- SW �3 y�tlSUR� T G3O'OUG ' �b{1C PN�Mj��l l/�t� <br /> (N JT �r� <br /> LEf3A LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS q p�G�' aP PHONE <br /> I�vb r-1 �.t����.� I � c�,,rn� ,dc � 6��� yaS- a�10 -�37� 7 <br /> TENANT NAME . CONTACT NAMIE PHONE <br /> • � ,xN�� __ .. � I �c+kw�-� — <br /> COHTRACTOR ADURESS ZIP COHTR UCEN8E1 <br /> , yn�nur �mc� t�-�n�- 8�2s .yy�`h l�u� "' '�e`p S�n�iOSSd°13G �-F <br /> Sr+v��n c �.�c�.s w .,�. �-ti,. �,,��r��-��b wa- as��s <br /> PHo��s- 3s - p�F . aa� <br /> PROPOSED USE OF BUILOINO BUlldng MeCIt9MC91 Additbn HEAT SOURCE <br /> prc..�u-t,e f�Sl c��f�C"?� PERMIT � Co�libMeUOn � Phltt�binQ WORK e Nlerallon D Elaclrb <br /> TYPE Damolitbn U Sipn TYPE 0 N.w U oes <br /> Spdnlder U RepeidMalnl. U Other <br /> CONTRACT VRICE OF WORK CT'OF EVERETT LOCAL 8ALE8 TAX CODE IB�106 <br /> WORK DESCtUP710N <br /> �LQPtcxc_� hu-{- u.x,.-l�� -t�p�n�• <br /> � PLUMBINO MECHANICAL <br /> NO. TYPE OF FlIfTURE OR REM N0. TYVE OF FlXTUNE OR ITEM <br /> WATER CLOSET _ A/C-AMANDLINO UNIT& <br /> BATHTUB _ FORCED AIR SYSTEM3 <br /> LAVATORY(WASH DASIN) _ HEAT PUMP <br /> SFiOWER _ UNIT HEATERS <br /> KITCHFN SINK d DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER RANOE HOOD <br /> LAUNDRY TFiAY � WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKINO FOUNTAIN _ DAS FIREPLACE <br /> FLOOR DRAIN _ DA5 RANOE <br /> BACKFLOW PREVENTER _ �AS PIPINO <br /> SINK(SERV�CE/BAFVMOP/ETC.) i : _ EXHAUST FAN <br /> OTHF.R _ OTHER <br /> � 1 HEHEBV CEHITIFY THAT I HAVE READ AND D(AMINED THIS MPLICATION AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIOINACES 60VERNINO THIS TYPE OF WORK WILL BE COMPLIED WITH WH[THER SPECIFIED HEREIN OR.,.. � <br /> NOT. THE 6RANTINO OF A PEPMIT DOES NOT PRESUME TOONE AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER'� ' , <br /> STATE OR LOCAL LAW FEOULATINO CONSTRUCTION OFi THE PERFORMNICE OF CONSTRUCTION. THAT 1 AM AUTHORIZEO BY TFiE , , ;. <br /> OWNER O S PROPERTY TO PERFORM TME WORK FOR WHICH APPLICA710N�S MADE AND 1 COMPLY WITH THE B1ATE�� „ ;� ,• <br /> CONT OHS W 10.27 CW AND 288. WA . . . . . � . . }, }��', „�f. : <br /> y 9 »' .y1 / /���/ . ,+�.j r � <br /> � � <br /> � e r ontred r nt el� '�, . . . ��p. ��i r, ;' j� <br /> . �. ., �,'y , .. � . . • . '�, '.`, . . <br /> t :, <br />� — . <br />