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� <br /> 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 /> SITE ADDRESS PARCEL TAX I.D.N <br /> ( � PERMIT M <br /> PJ «ol�l oU �y aS/CJUS M l ` OS <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS LP PHONE <br /> �rne���. PP-�r ��� (3r�X��t�. a8d�� Nas <br /> TeNANTNAME CONTACTNAME aga �� � <br /> c^ � �_ PHONE <br /> � `'�Y�1� <br /> CONTRACTOR 1^n�j.� �/yy,e ���C ADDRESS r��5' y ''�h <br /> �Y�ZU`C SQfUZC�$ ed �p, �` �� �P CONTp.UCENSE/ <br /> PHONE � � �'{wri IN�- �lg�S seN i o ss a`I 3o H <br /> �l a-S- 3 SS- � � '� �fc.-r ��y <br /> PROPOSED USE OF BUILDING Building (7�.Mechanicel <br /> j�,p PEHMI7 Combinelion �`( Plumb(n Addition HEATSOURCE <br /> �rl��� r�S """�he� TYPE K 9 WORK �Alterelion Electric <br /> Demolilion v Sign 7YpE New Gas <br /> Sprfnkler RepalAMalnL Olher <br /> CONTRACT PRICE OF WORK CRY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 'RePE��nY�arE- ��o�-�t- �v�.�. <br /> ' PLUMBING MECHANICAL <br /> N0. TYpE OF FIXTURE OR ITEM <br /> N0. TYPE OF FlI(TURE OR ITEM <br /> _ WATERCLOSET ,_, q/C-A/HANDLINGUNITS <br /> _ BATHTUB <br /> _ LAVA70RY(WASH BASIN) .— FORCED AIR SYSTEMS <br /> _ SHOWER _ HEAT PUMP <br /> _ KITCHEN SINK R DISPOSAL — UNIT HEATERS <br /> _ DISHWASHER _ CLOTHES DRYER <br /> _ UIUNDRY TRAY RANGE HOOD <br /> __ CLOTHES WASHER � WATER HEATER <br /> _ URINAL _ METAL FIREPLACE/STOVE <br /> _ DRINKING FOUNTAIN — FIREPLACE INSERT <br /> .._ , FLOOR DRAIN _ GAS FIREPLACE <br /> _ BACKFLOW PREVENTER —. GAS RANGE <br /> _ SINK(SERVICE/9AFUMOP/ETC.) — GAS PIPING <br /> _ OTHER _ EXHAUSTFAN <br /> ,_ OTHER <br /> I hiEREDY CERITI�Y THAT I HAVE READ AN�EKAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GR�NTING OF A PEPMIT DOES NOT PRESUME TO G�VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> O'NNER OF THIS PROPERTV TO�PERFORM THE WORK FOR WHICH APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR ORS LAW 18.27 RG�W AND 29fi,Z00 WAC. <br /> \ � 1 <br /> � ��� / �S^� � <br /> Signalu ol OwneNC! Iraclor/Authorized Agent ate <br /> L _ <br />