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� t_ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVII:ES <br /> 3200 CEDAR STREET, EVFRETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> ��IS -!/ <br /> SITE ADDREES _ PARCEL TAX IA. � PERMI7 s <br /> �- I 00 Zl�1 P10 //0�• 2 <br /> LEGAL LOT NO. BLOCK TMCT <br /> DESC. <br /> OWNER ADDRESS 21P PMONE <br /> fare�Jl�' ,�. 7. • C�Vl9.�., 2�O�x.� S�"f�� <br /> TENANTNAME � ,/nh/� M.P�� �IIT� F�I(1M'j(J► � �v �+ ," ��V IZZ <br /> S IY�I , W 'I lj{I 1 1!I <br /> CONTRACTO �y � [,( ^ IS/� ADDRESS("'�lq9 � �UP� ��NTR��OENgE�� <br /> (JU 1 l�L. L�f I U ' �� Vu ' " � /�A�r� �j <br /> PHONE �� �"'r <br /> ?1af1 �� �3 <br /> P R O P O S E D U S E O F B U I L D I N G �Buildin g Mechanical ynAddilion NEAT SOURCE <br /> I PERMIT Combination RI..( Plumbing WORK j�{Alteration R Elepnc <br /> TYPE Demolition U Sign TYPE �.�j New �` Gas <br /> Sprinkler U Repair/Maint. LJ Other <br /> CONTRACT PRICE OF WORK I CITY OF EVERETT LOCAL SALES TAX CODE IS 7106 <br /> WORK DESCRIPTION � �1(� �D �� ' v'• '� ��� <br /> ���fi �pri�� � '�i.u�rcs� � pt�i�c�F �-i� <br /> aan-+ zm rvw'� f- <br /> PLUMBI G MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATERCLOSET _ NC—AIHANDLiNGUNIT3 <br /> BATHTUB _ FORCEGAIRSYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HFJATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES f1RYER <br /> �ISHWASHER _ RANGE HOOD <br /> IAUNDRYTRAY _ WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS 1=1REPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICEIBAR/MOPIETC.) _ EXHAUST FAN <br /> OTHER __ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAMt TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAVJS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL 9E COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOE�NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> ��TATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> �' OF THIS PROP 7Y TO PERFORM THE VJORK FOR NMICH APPLICATION IS MADE 4ND I COMPLY NATH THE STATE <br /> ICONT LA R W AN 296.2_ _00 WAC. � <br /> �I \ <br /> e o OwneUContraclorlAuthonzetl Agent ate <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />