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,- <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8657 <br /> SITE ADDRESS PARCEL TAX I.D.N PERMiT M �1 <br /> b �QJc�— <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> o f'[' I � ��'�1\ �C N � RCA�y Zn �'C V�1�2Q�PHONE�"�'T I-�J <br /> 9 <br /> TENANTNAME I CONTACT NAME PHONE <br /> CONTFlACTOR ����s ADDRESS ��� ���L �C CONTR.IICENSE N <br /> PHONE ��C "���L'� A�L1\ �� ` ��WMV`'t�I <br /> L� <br /> PROPOSED USE OF BUILDINO Bullding �MecheniCal Addlllon HEAT SOURCE <br /> PERMIT R Combinetion Plumbing WORK R Alieratlon � Electric <br /> TYPE � Demolilion Sign IYPE � New Oes <br /> Spnnkler RepelrlMeinl. Olher <br /> CONTHACT PRICE OF WORK �O CITY OF EVERETT LOCAL SALES TAX CODE IS 9f 06 <br /> r <br /> WORK DESCRIPTION <br /> �ur,,,a,� � rJ�� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OH ITEM NO. TVPE OF FIIfTURE OR ITEM <br /> WATER CLOSET A/C-A/HANDLINa UNITS <br /> BATHTUB L FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANOE HOOD <br /> LAUNDRY TRAV = WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> UFINAL FIREPLACE INSER7 <br /> DfiINKING FOUNTAtN 13AS FIREPLACE <br /> FLOOR DRAIN CiAS RANaE <br /> BACKFLOW PREVENTEF = GAS PIPIN6 <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUSTt9N ��� <br /> OTI�ER �,_ OTHER �r-'J <br /> I HEREBY CEFITIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> �ROVISIONS OF LAWS AND ORIDINACES OVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEFEIN OR <br /> NOT. TH GRANTING OF A PEFMIT DOE NOT PRESUME TO GIVE AUTHOPITV TO VIOLATE OH CANCEL THE PROVISION OF ANV OTHER <br /> S1AT CAL LAW REGUV+TIN CO STFUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br /> OW R F T ER O E O THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CO R R 2 R l�Y ND 2 200 V�AC. <br /> � Z-Z -02 <br /> Signa r Irac or/ ho ized Agenl ele <br /> _ . � <br />