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� -- <br /> � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 i <br /> i <br /> SITE ADDRESS PARCEL TAX I.D.8 PE,F)MIT u � <br /> �o�i wlEkM� �o� y �i-�bnoo �o� � 30 ���0 - ! <br /> LEGA LOT NO. BLOCK TRACT � ��" � <br /> CESC. 1,2,�J lj(� jL1tivFlLS FIR`�{ {��� <br /> OWNER ADDRESS ZIP PHONE � <br /> NaR 1 �R-Er��t ` 1 ' I �['D7.�1 � <br /> ilo ft� �K�avac o� War�n���n ' 2(001 Yys�rbe�pJ�. 'f'2�i• 793 •37s{� <br /> TENANTNAME C ACTNAME PHONE � <br /> ���►�� ����� d� W a � �,�� �z� . �z. z,s3 � <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE M <br /> To '�- 1��1� <br /> PHONE ��������: <br /> � <br /> ?ROPOSED USE OF BUILDING Bwlding 11 Mechanical Addition HEAT SOURCE I <br /> I PERMIT �ombinalion �_� Plumbing WORK �Iteration I n Electric 'i <br /> TVPE Demolilion U Sign lYae New K Gas � <br /> Sp�inkler(a ol heads) Repair/MainL LJ Other � <br /> i <br /> CONTRACT PRICE OF WORK �((i���y) , CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 � <br /> WORK DESCRIPTION � p i <br /> Irlke�+lt�l +�r1�+n�1 I n.l�'-��vE•nG-r+}s� J�rul G�cro�,�5 /rr �3/o�c{ �-Mi�e+2.. <br /> �.1 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FlXTURE OR REM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASN 9ASIN) HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/8AR/MOP/ETC.) EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREOY CERITIFY THAT I HAVE READ Al1D EXAMINED THIS APPL�CATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PAOVISIONS OF LAN'S AND ORIOINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. TIiF GRANTING O�A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OF LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPER PEflFORM THE WORK FOR NHICH APPLICATION IS MADt AND I COMPLY WITH THE Sl"ATE <br /> CONTR OHS LA 827 RC 296. 0 WAC. <br /> . �7/oz Q3 <br /> Si�naWre ot wnedCon raclodAuthoriz d Agent Date � ��� <br /> \I� <br />