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r ERMI�' APPLICAT- �N � �5►� G��tIS+,��ud. <br /> CITY OF EVEFiETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> S��iDR SS � �� PARCEL TAX�.D.N <br /> PERMIT M <br /> "V Gb4 3�►l�A2��oo oaio-o3S <br /> LEGA LOTNO. BLOCK 7"RACT <br /> DESC. 1 �nO � r. ' <br /> -� ui <br /> OWNIcR ADDqES <br /> /� A LP PMONE <br /> S'rD��t���}rAG��V ?�7iOl l�0��it• -Hue, 419- 339- 120 ., <br /> TENA} NAME �R�'(Q�.� 1� �� COM.ICT NAME <br /> , / 210� 33YJ(S�- PHONE <br /> V OICR�� �C��o�� , C�etl- WA 487..� <br /> '�i.w� Sr�.�u���� ' 4as-2sq-�.Ga�'' <br /> CONTRACTOR —TB� ADDRESS � <br /> ZIP CONTR.LICENSE k <br /> PF10NE �(�ir�:{/� ��J� <br /> � <br /> PROPOSED U5�OF BUILDING Building D Mechanical <br /> PERMIT R Addi�ion MEATSOURCE <br /> Combination U Plumbing WORK �( Alleration � Electric <br /> . �//1 f 1YPE Demolition U Sign IYpE I, New Gas <br /> W��Z� Sprinkler L� RepaiNMaint. Other <br /> CONTRACT PRICE OF WORK � J�O CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � (�-� <br /> WORK DESCRIPTON <br /> l.t�C�U1CF Cn vad4�ro-cQ.i.o �e ►�a.��- 1n �Q _- �P.+ti.tns o.t�.C,l�,�.'�i <br /> �fac�.+-►,e�' �u D wi�i� � �n al.(ey . �� �— <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF fl7CTURE OR ITEM N0. TYPE OF FIXTURE OR REM <br /> _ WATER CLOSET _ A/C—A/HANDLING UNITS <br /> _ BATHTUB _ FORCED AIR SYSTFMS <br /> __ LAVATORY(WASH BASIN) _ HEAT PUMP I <br /> _ SHOWER _ UNIT HEATERS <br /> _ KITCHEN SINK& DISPOSAL _ CIOTHES DRYER <br /> I _ DISHWASHER _ RANGE HOOD <br /> _ LAUNDRY'�RAY _ WATER HEATER <br /> � CLOTHES WASHER <br /> _ URINAL _ METAL FIREPLACE/STOVE <br /> DRINKING FOUNTAIN _ FIREPLACE INSER7 <br /> ! _ FLOOR DRAIN _ GAS FIREPLACE <br /> _ BACKFLOW PREVENTER - GAS RANGE <br /> I _ SINK(SERVICE/BAR/MOP/ETC.) - GAS PIPING <br /> i _ OTHER _ EXHAUSTFAN <br /> _ OTHER <br /> I - _ <br /> � - <br /> � - <br /> II HEREBV CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AN�CORRECT. ALL <br /> NOTVT E GRAN NG OF A PER'MIT OES NOT PRESUMEITO G E�AUTH�ORITY TO VIOLATELOR CANCEL T EHPFOVIS OIN O�F ANY OT ER <br /> STATE OR LOG1L LAW REGItI_qTING CONSTRUCTION OR THE PERFORMANCE OF CON5T�UCTION. THAT I AM AUTHORIZED BY TH[ <br /> OWNER OF THIS PROPERN TO ERFORM THE WORK FOR WHICH APPLICATION IS MADE ANO i COMPLY WITH�lHE STATE <br /> CON RACTOF�L1W 1 .' RC AND 296.200 WAC. <br /> gna re ot Owner/Co t ct Aulhorized Aganl �✓�pate <br /> 1/� <br />