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j PERMIT APPLICATION <br /> i CITY OF EVERETT PERMIT SEFZVICFS <br /> I 3200 CEDAR STFiEET, EVERETT, WA 9820? <br /> I 425-257-8810- FAX 425-257-8857 <br />� SITE AD�RESS 3 7Z�o CJR-Z'/k��+%�'Y PARCEL TAX I.D.k PERMI7 a <br /> - �s.a� w� M�r� � � - 0�4 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNEfl � ADDRESS ZIP PHONE <br /> . � . 'Z�� <br /> �1'�'lUT DE✓�COr'HE-.UT 3��� L`' Ri�l�D1J1��+ 7/S — ( 0 5 G <br /> TEiJR NT NAME CONTACT NAME PhONE <br /> i�iN'1�-S /'1. f'1�C2UM �o tiJ �'���r-r,p �,�-�es 3 �o —7�it.�— 73d� � <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE M ��, <br /> �� s r-rF,��-�Nc- c o. 5�a ��-s 7 r, �„� s � G 5 F I �f�G i. l 47 J D � <br /> PHONE �'�O GlJ IZ a� � l.✓ kI" (g�72� I <br /> PROPOSED USE OF BUILDING Building echanical Addition HEAT SOURCE i <br /> PERMIT R�.�( Combinalion Plumbing \YORK � R�.j�,Ileration �lectric <br /> p�r��rrEr�� S i TYPE �j Demolition Sign TYPE � New � Gas <br /> u Spfinkler(a of heads) RepaidMaint. LI Gher <br /> i <br /> CONTRACT PRICE OF WORK GTY OF EVERETT LOCAL SALES TAX COOE IS 3105 i <br /> WORK DESCRIPTION � <br /> ��usTr}� puc_� wo�cc� G2�c.:_ES <br /> rj �F f=c�S E-�2 S I� 3 �,�NF}U 5 i � <br /> i <br /> F�tis <br /> PLUMBING MECHANICFL <br /> NO. TYPE OF FIXTURE OR IT'cM NO. TYPE OF FI7CTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—FVHANDLING UNITS <br /> BATHTUB FORCED AIR SYST[MS <br /> LAVATORY (WASH BASIN) _ HEAT PUMP — ��i S� ���— <br /> SHOWEFl UNIT HEAT[RS <br /> KITCNEN SINK& DISPOSAL CLOTHES DRYER <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 GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) 3 EXHAUST FAN <br /> OTHER OTHER_��-T� W�L1� <br /> —I <br /> i I IIEREBV CERITIFV THAT I HAVE READ AND EXAh11NED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WQRK INILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DUES NOT PR[SUTAE TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE . <br /> OWNER OF THIS PROPERTY TO PERFORM THE IVORK FOR WHICH APPL�CATION IS Iv1A�E AND I COh1PLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 2Q6200 WAC. I <br /> � •-�, ���.�ar, 1/ /d/�� <br /> S'ignaWre of Owner/ onlra odAuthonz Agent ale ( � <br /> -- 1 •1-- <br />