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PERMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> StTE ADDRESS PARCEL TAX I,D.� PERMIT t <br /> 6 z h� w,� �oyo�-o,� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. _ ! �O <br /> OWNER ADORESS LP PH E <br /> �/� f �1�. / .Zs� - Syoo <br /> TENANT NAME CONTACT FOR PERMR PHONE <br /> �1�}n !� 01 /7'�C�✓{CYF I /)�C��4vL1 /�-1"`47�i4rc/ —l.ZS"���-2g'� <br /> CONTRACTOR �/G J�vo(� / ADDRESS p fi� �k 3/ ZIP CON7R.LICENSE• <br /> iY '7'r�+ �Lw iU✓� l�s�2� `�J�'►'+u� �C /b�rc� <br /> PHONE �,�— .2.� �-� z0 ��r ���-..y�v>y �al. Syzi3 iI�/I R�J7 /�� <br /> PROPOSED USE OF BUILDING Building MeChanical ACditlon NEAT SOURCE <br /> /� ,/ PERMIT Combinatbn Plumbing WORK Ntxatbn EbcMc <br /> �{� � /, TYPE Dem0lifbn Sign TYPE � � Gaa <br /> /V ! \ Sprinkler epaidMaint. Otlier <br /> CONTRIICT PRICE OF WORK CtTY OF EVERETT LOCAL SALES TAJ(CODE p 7706 <br /> WORK DESCRIPTION <br /> , �e /Pv a � <br /> PLUMBING MECHANICAL <br /> N0. 7YPE(�F FIX7URE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILEn A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNITHEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGEHOOD <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/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I <br /> I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANU GORRECT. ALL <br /> I PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WFiETHER SPECIFIED MEREIN OR <br /> � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TFiE PROVISION OF ANY OTMER <br /> ISTATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTIUN. TNAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOR THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TNE STATE <br /> CONTRACTORS U1W 18.27 RCW AND OD WAC. <br /> /- (O � <br /> I Signature of Owner/ContractorlAuthonzetl Agent ate � <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED L <br />