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�RMIT APPLICATICIN <br /> � CITY OF EVERETT PERMIT SERVICES <br /> '�"' 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.N PERMiT: <br /> ! � - -�� PLL � F ��� _ Uo� -D <br /> LEGA LOT NO. 9LOCK TRACT <br /> DESC. <br /> OWNER ADDRESS DP PHONE <br /> 7�_c'i�1 FR;Y/,�> � '% �� 1�.C, . / 9Yoo /9yrfl q � X/ � 98o7z yZ5 -�iB� -S2oo <br /> TENANTNAME CONTACTNAME � PNONE <br /> D�EBo�� G��fCGE rRA��E.I� /��-s- S83-°I2�-�i <br /> CONTRACTOR ADORESS ZIP CONTR.LICENSE N <br /> ME.P.\� 1`nE('\\�`; `�rP ` 9630 153f� AJE. TI��. 9805(o n�R�TM1163GM <br /> PHONE <br /> �t1..S - Pig", `�Z21. <br /> PROPOSED US�OF PJILDING � Building Mechanical Addition HEAT SOURCE <br /> PERMIT Combination Plumbing WORK�Alteration �Electric <br /> TYPE Demolition Sign TVPE New Gas <br /> Sprinkler RepaiNMaint. OMer <br /> CONTRACT PRICE OF WORK Ac ��q,�J Cj z OO CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> -Y <br /> WORKDESCRIPTION ��1�'�qll. ONF. �o0f�"(DP GAS/C LFC-�IR��- WItN DUL"T���ORK $' GRILL�S � <br /> ���c. ir�'�A��� A �+�� ` , GAS pipiNG . <br /> PLI,MBING MECHANICAL <br /> NO. TVPE OF FIXTUHE OR�TEM NO. TYPE OF FIXTURE OR ITEM <br /> WATERCLOSET I A/C—A/HANDLINGUNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAi'PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY � _ `NATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> i URINAL . _ FIREPLACE INSERT <br /> �i _ DRINKING FOUNTAW _ GAS FIREPLACE <br /> ! PLOOR DRAIN GAS RANGE <br /> BACKFLOW Pf7EVENTER �- GAS PIPING <br /> i = SINK(SERVICE/BAR/MOP/ETC.) i EXHAUST FAN <br /> OTHER OTHER <br /> _ = a � <br /> ' I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL <br /> PFOVISIONS OF;AWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> �I NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> OWNER OF T�HIS PROPERTY TOTPER ORM THE WORK FORHWBIICH APPLICATIONFS MADE ANDTIOCOMPLV WI H THE STATE�Bv THE <br /> ICONTRACTORS LAW 1827 RCW AND 296200 WAC. ' <br /> � ` 6 I OZ <br /> SignaWre of OwnedContra ut onzed Agent Oate <br />