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PERMIT APPLICATION ; <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS � PAZCEL TAX I.D.M P�iMIT ti � <br /> 2 g„vo�l.wa oo�k3'1"�g�9ol�0o I .L 4/Dij �� ( <br /> LEGA LOTNO —O7CpK� 7RACT � <br /> DESC. ��. 'LG I 1 �S. 5�1.��5 RGR� ; <br /> OWNER ADDRESS LP PHONE t <br /> 8bb S�6bltnr ��I� Rock.e�ll.i,v a�- ¢p.S 21 z • 2210 <br /> C�Et.�'�u�' 3'lno 1'1Dlc�in.,A .��t�vc.t�,W fF� a$Zo 1 <br /> NANT b�ky � � CONTACTFORPERMR ��O NE 3.3M� PI. PHONE � <br /> T FFce- w"q""� Q�e�ti �PN� sa�y yz.f•b"i7•Zioo `q <br /> U BGILvµ.t�Ull� 4b00y 1 <br /> CONTRACTOR'r.$ . Q, /� ADDRESS LP CONiR LICENSE R A <br /> PNONE /A /µ�/� 1��� , e� S�S �"`� '" //�/�'Y I <br /> V� <br /> PROPOSEDUSEOFBUILDING BUilditlg D Mechanical I� Addifion HEATSWRCE i <br /> I pERMR Combination U Plumbing WORK �Alleratlm f7 EMWic � <br /> ��'��"�`} W ) 7YPE Demolition U Sign TYPE D r+� R caz j <br /> ��• -��(tiy� Sprinkler U RepaklMainL U OC�er � <br /> CONiRACT PRICE OF WORK �� O O�O CITY OF EVERETT LOCAL SALES TAX CODE i5 3705 <br /> � <br /> WORK DESCRIPTION <br /> 15(oIo c.F. �ni�lia l �-t.u�..�4- �M�w.►c.w-w�' �'"1'' '��� 'eb�n��w� M�lwles r.�.w <br /> �AV�"'�T1JH W���Y�Pilil) ✓C$'�-Vt10M"J�ht�W IMQ-C�.P�C�JI. OLLI.c�iWOVk--. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FURURE OR ITEM NO. . 7YPE OF FU(TURE OR REM <br /> WATER CLOSET(TOILEn AIC-AM/W DL1NG UNITS <br /> — gq7}►�g FORCEDAIRSYSTEMS <br /> '�i IAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY T WATER HEATER <br /> CLOTHES WASHER METAL FIREPIACFJSTOVE <br /> URINAL FIREPLACF INSERT <br /> DRINKING FOUNTAIN GAS FIRENIACF <br /> FLOOR DRAIN GAS RANGE <br /> S BACKFLOW PREVENTER GAS PIPING <br /> � SINK(SER IC�EIB-AWuK/MO�/ETC.) � EXHAUST FAN <br /> _� OTHER � _ OTHER <br /> �_ f Gt w.:w(tiV-l. — — <br /> I HEREBY CERITIFY THAT I HAVE RF_AD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CARRECT. N.L <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNINv THIS TYPE OF WORK WILL BE COMPLIED WITH WHElHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOI.ATE OR ClWCEL THE PROVISION OF ANY OTHER <br /> iTATE OR IilCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCiION. THAT 1 AM AUTHORIZED BY THE <br /> JWNER O4-THIS PROPERIY TO PERFORM THE WORK FOR WHICH MPLICATION IS MADE AND 1 COMPLY WITH TNE STATE <br /> CONTNAc:T RS LAW 1827 RCVJ AND 296.200 WAC. <br /> • (� l� <br /> Si aWre of OwnedCon racto lhorized Agent Dale �� <br /> DEBIT& CREDIT CAI4DS ARE NOT ACCEPTED <br />