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1 <br /> � � ��}� FERMIT APPLICAT N <br /> �'��i�— CITY OF EVERETT PERMIT SERVICES <br /> ��'r 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 ��� �� <br /> PARCEL TAX I.D.# PERMIT^,�y�, ' <br /> SITE ADDRESS � g$-�i-e"t' <br /> o � � ����a A�,° <br /> LEGA LOTNO. BLOCK TRACT �S `r\ S —�1— � <br /> DESC. � � �'(�4-- � pHONE <br /> OWNER ADDRESS �,�`�� <br /> � �\ ��9 � � �-�- \4qo�� ���'� 0`�•� �1�� 9��a <br /> CONTACTNAME PMONE <br /> TENANTNAME e . <br /> ��:�a.�.n\� 4���C�h C�Qu�.9� <br /> CONTRACTOR ADDRESS LP CONTR.UCENSEY <br /> c`�`�� m�,cA�.;c.a.9- Q lo�d �`S'�°�(L,A �i� 98a�o? cc��.n:, �l�3 <br /> PHO��aS $� - 9a � <br /> Buildin MeCheniCel Addition I HEAT SOUNCE � <br /> PROPOSED USE OF BUILDING � 9 n Electric <br /> I PERMIT Combination � Plumbing WORK B Alteration � Gas <br /> 7ypE Demolition Sign TYPE g NgW Omer <br /> Sprinkler RepairiMaint. <br /> CONTRACT PRICE OF WORK CITV OF EVERETT LOCAL SALES TA%CODE IS 31�5 <br /> �ORK DESCRIPTION 5���, `(��� � (/\Vl-�-�� �'` `) � <br /> c�u-:�.+9�s� �,.x�\t � G.c. �..�:�..i.� <br /> PLUMBING MECHANICAL <br /> ryp, TVpE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET _ A/C—A/HANDLING UNITS <br /> BATHTUB _ FORCED AIR SVSTEMS <br /> �_ LAVATORY (WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNITHEATERS <br /> �. KITCHEN SINK&DISPOSAL _ CLOTHES DRYER <br /> DISNWASHER � _ RANGE HOOD <br /> _1_ LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER _ METAI 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 — — <br /> I HEREBV CERITIFY THAT I HAVE READ AND EXAA7INED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> i <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNIMG THIS TVPE OF WORK WILL BE COMPLIED WITH WiiEfHER SPECIPIED HEREIN O <br /> ' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OA CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOC��L LAW REGULAT�.NG CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I.4M AUTHORIZED BY THE <br /> �i OWNER OF THI3 PROPERTY TO?ERFORM THE WORK FOR WHICH APPLICATION�S MADE AND f COMPLY WITM THE STATE <br /> CONTR TORS L AW 182�RCy?✓ D 2962001NAC. <br /> .��� ,=��1�,'" .��✓ �.� �:�oZ poa� -ooa <br /> Signature Ow edCuntractor/Authonzed Agent �e� <br />