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� <br /> ;- R-RMIT APPLICATI N � <br /> �wi�� ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 4^�-257-8lt10 <br /> lK'�RI <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> ,�,ir, i,,hi a ,,, i_ i, � izi:rr. w� es�ni on.�3�s��o�n�iou rn f�sos- d57 <br /> LEGAL LOT NO. BLOCK ITRACT - — <br /> DE <br /> OWNER ADDRESS <br /> PHONE <br /> � i<i a�u It. uin+l it r 'r�i�, iin�;ra nvl. <br /> • evituerr. ti�n �ix�ui ii�zi;n;-u�;o <br /> TENANT NAME CONTACT NAME PHONE <br /> rnnni.nilll.l. �,� si.�-;i,� �i;; <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> I �\til \l�:\II�IiIII�:�II�KC�(i111'ANl' I'G01112NUAVI�: NI[ <br /> I�Ati I 11'I I(�II�'lll <br /> PbONE ��'`�H��'-��'�' hni�:i.nHi>. ���n ��soa� n��i�� �am <br /> PROPOSED USE OF BUILDING BWld�np M�ehan�ca Additlon HEAT SOURCE <br /> PERMIT Combinellon ' Plumbinp W�RK , AlleraUon Elec�ric <br /> TYPE Demolilion S�Q� TYPE New as <br /> � � Raos�rlMalnt Ihrtr <br /> CONTRACT PRICE OF WORK �;.�q.pp CITY OF EVERETT LOCAL SALES TAX CODEIS 7t05 <br /> WORK DESCRIPTION <br /> Rcniu�c Rrplacc I�.Icclric N';itcr Ilrnlcr <br /> UMBI MECHANICAL <br /> NO. TYPE OF FIXTURE OR 17EM N0. TYPE OF FIXTURE OR ITEM <br /> _____ WATER CLOSET _______ A/GA/HAIJDLING UNITS <br /> _______ BATHTUB ____ FORCED AIR SYSTEMS <br /> ______ LAVATVRY (WASH BASIN) HEAT PUMP <br /> _______ SHOWER ____ UNIT HEATERS <br /> ______ KITCHEN SINK 8 DISPOSAL __ CLOTHES DRYER <br /> _______ DISHWASHER __ � _ RANGE HOOD <br /> _____ LAUNORY TRAY _.__ � WATER HEATER <br /> ______ CLOTHES WASHER ____ METAL FIREPLACElSTOVE <br /> ______ URINAL _ FIREPIACE INSERT <br /> _______ DRINKING FOUNTAIN __ GAS FIREPLACE <br /> ______ FLOOR ORAIN __ GAS RANGE <br /> ______ BACKFLOW PREVENTER _�._ GAS PIPING <br /> ______ SINK (SERVICEIBAR/MOPIETC.) EXHAUST FAN <br /> ---- 07HER-------------- --- <br /> ----- OTHER_--------------- <br /> I HERFBY CGRTIFY THAT 1 HAVE READ AND E7G4MINED THIS APUCATIONl�ND HNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOV[RNING 7HIS TVPE Of VJORK WILL BE COMPUED WIHT WHETHER SPECIFIFD HEREi <br /> OR NOT. iME GRANTING OF A PERMIT DOES N07 PRESUME 70 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTMER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TME PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED <br /> BY TME OWNER OF THIS PROPEHTY 70 PERFORM THE WORK FOR WHICIi AFPLICATION IS MAOE AND I COMPLY WITH TNE STA7E <br /> CONTRACTORS LAW 1827 RCW AND 496.10�WAC. <br /> �Signaturo of Owner/ContractorlAuthorized Agan! Dete <br /> � . . � • . � .� 05�?L��OUS <br /> ui ��� <br />