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P�iMIT APPLICATIO� <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 pEp �T q <br /> i I A'� or�' �t� p2 <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADOfiES3 LP PHONE <br /> ��it�. 1�o�er�le� ��lyOU I`�4Y�+ /kY� N� Woa�in.�ll� 9 7L <br /> TENANTNAME n CONTACTNAME GHONE <br /> IZGn�y�S �i�Q � I �^'� N�1 ►l�e ��y Zs�b �63 17'!N <br /> CONTMCTOR ADDRESS ' S ZIP CONTH.UCEN3E M <br /> EVers�ee.. R�Fr�ye��{-ro„ Irc, '7Z'1 Ics��s�., qrn�t <br /> PMONE <br /> Zc6 �� �7d'1 EJfJWS'�Zo►.p7 <br /> PROPOSED USE OF BUILDING BUilding haniCal Adtlition MEAT SOURCE <br /> / PERMIT B Combinalion Plumbing IWORK �Alleration ���� <br /> 0���« ! S^o �PE D Demolition Sign 7vpE New Gas <br /> D Sprinkler RepaidMaint. �Other <br /> CONTRACT PRICE OF WORK � � L��! — CITY OF EVERER LOCAL SALES TAX CODE IS 3106 <br /> � <br /> WOHK DESCRIPTION � <br /> t�,.��.,,,o�l� T� � �^s�ll � F�S <br /> PLUMBING MECHANICAL <br /> I NO. TVPE OF FlXTURE OR REM NO. TYPE OF FlXTURE OR REM <br /> WATER CLOSET _ 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 _ RANGE HOOD <br /> f _ LAUNDRY TRAY _, WATER HEATER <br /> , _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> � _ URINAL _ FIREPLACE INSERT <br /> _ DRINKING FGUNTAIN . _ GAS FIREPLACE <br /> � _ FLOOR DRAIN _ GAS RANGE <br /> , _ BACKFLOW PREVENTER � GAS PIPING <br /> _ SINK(SEAVICE/BAR/MOP/ETC.) "7 EXHAUST FAN <br /> _ OTHER _ OTHER <br /> — � a7���vr � Tt <br /> I HEREBY CERI7IFY THA71 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW 7HE SAME TO BE TRUE AND COflRECT. ALL <br /> PROVISIONS OF LqWS AND OqIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPEC�f1ED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHEH <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CON3TRUCTION. THAT I AM AUTHORIZED 8V THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND t COMPLV WITH THE STATE <br /> CONTR LA �- <br /> / <br /> S`ig ure d(,onlrectodAuthonzed Agent ete <br /> c <br />