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PE. ;MIT AP�PLICATIO. � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADORESS PARCEL TAX I.D,w P MI7 w <br /> � D - <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNEfl ADDRESS ZIP PHONE <br /> 7ENANTNAME � CONTACTNAMF PHONE <br /> CONTRACTOF ADDRESS 21P CONTH.LICENSE M <br /> Lk�c�Q�DG� i'w,na,,.ii / m�u 13508 i2�f'W K��uu.t.�a Wp. 98ua.{ <br /> PHONE <br /> yzs-a�� _ 925�0 <br /> PROPOSED USE OF BUILDING Building I-"1 Mechanical Addition HEAT SOURCE <br /> PEHMIT � Combination �_�6lumbing WORK AI alion � Electric <br /> TYPE Demolilion LJ Sign TYPE ew Gas <br /> Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK CITV OF EVERE7T LOCAL SALES TAX CODE IS 3505 <br /> WORK DESCRIPTION <br /> v/���:`Il. C�Q.oJM.A p.�Ma�r.Il. <br /> � Jnlo�n. G�t-o���a �2��C �2A��•1�4Gci I 7D� �✓r <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NC. TYPE OF FIXTUHE OR ITEM <br /> WATER CLOSE'f _ A/C—A/HANDLING UNITS <br /> BATHTUB _ FOACED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DFYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> ' DRINKING FOUNTAIN GAS FIREPLACE <br /> � _ FLOOR DRAIN _ GAS RANGE <br /> � BACKFLOW PREVENTER GAu PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) _ EXHAUST F.4N <br /> � OTHER OTHER <br /> � � Qoa� �i /L4�n/i — – <br /> I HEFEBY CEFI7IFY THAT I HAVE READ AtlD EX.4MINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAbVS ANO OAIDINACES GOVERNING THIS lYPE OF WORK WILL BE COMPLIEJ WITH WHETHEti SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PEPIdIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TH[PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNEF7 OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ( 'TRACTOf�LAW 78.2��IJD 296.200 WAC. ����1/`� <br /> � / /J/Yl <br /> %/u��/� � <br /> ' Signalufe of OwnedComractodAuthonzed Agent � <br />