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— ----� —� <br /> , PERMIT APPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> i 3200 CEDAR STREET, EVERETT, WA 96201 <br /> � 425-257-8810- FAX 425-257-8657 <br /> , <br /> � 7 0 O - U� <br /> SITE ADDRESS PARCEL TAX I.O.8 PERMii a <br /> I :3 ��-� 3�U�Dw�4r� -.- c, -Q3 � <br /> I LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> ON!";ER ADDRESS ZIP PY.ONE <br /> I <br /> G�Mv-z !-1o�o�n�o-5 37L� �(���DWwy 4� S"zr � - 1 � �U <br /> TENANT NAME COIJTACT NAME PHONE <br /> �LYrt�� aE�cJER/1� CotiJiR�c,-o (ZO �V �� u�Prue� 3�u -7q`•�750[� <br /> CONTRACTOR ADDRESS ZIP CONTR.IICENSE M <br /> I G�'� 5 �-(EA-'T�/CX-{ I ti' L SU o �A$T p7d�+M' 'i 817L , <br /> PHONE <br /> � � �, —�q �, - � �o�, GS���r-�c2�47JC� <br /> I PROPOSED USE OF BUILDING Building �q�0lechanical Addition HEAT SOURCE � <br /> O � �_ � G� PERMIT R Combination H Plumbing WORK Airerauon �lectnc <br /> TYPE Demolition U Sign 7YPE w as <br /> S %�/a-�--� Sprinkler(a ol heads) Pepair/Maint. Other <br /> CONTRACT PRICE OF WORK �� �� 1 U v CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> / <br /> WORK DC-SCRIP770N <br /> I �(JS T�c_ � Ov�—T LJa /Z(L (7 IFt=Us�—�5 <br /> � ���ia- G P r � c_S �" �-7�� S �r irJ �.. <br /> � (LCUU � �vi' V�U( ( <br /> PLUM8ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> VNATEH CLOSET (TOIL6T) A/C-A/HANDLING UNITS <br /> E3ATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) HEAT PUMP <br /> SHOW[R UtJ1T HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRY[R <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTH[S WASHER METAL FIREPLACE'STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHEH OTHER DV C i (,✓d 2 �G <br />� I _ ------ _ ��! r �[/t ���.S <br /> I <br /> I I HEtiEOV CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAfdE TO BE TPUE AND CORPECT. ALL <br /> I PqOVISIONS Of 11+W5 AND ORIDINACES GOVERIJING THIS T'PE OF WORK WILL BE COMPLIED WITH WHETHEP SPECIFIED HEREIN OR <br /> tJ07. THE GRANTING OF A PERI�IIT DOES NOT PR[SUME TO GIVE AUTHORIN TO VIOIATE OR CANCEL THE PROVISION OF ANY OTIIER <br /> S fATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONS i RUCTION. THAT I Ald AUTHORIZED BV 7"NE <br /> � OWN[P.OF THIS PRQPERTY TO PLRFCRtd THE WORK FOfi INHICH APPLICATION IS MADE AIJD I COMPLY WITH THE STATE <br /> �,I CONTR RS LAW 7827 RC��W jJAND 296200 WAC. <br /> , ,Q'V��__��� �� �� � � � <br /> i, S- ature of Ownedi.ontractodAuthorized gent Date �/ <br /> Z <br />