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PE..�MIT APPLICATIG. � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C�DAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE AD�RESS PARCEL TAX I.D.M PERMIT M <br /> 22� y �� rnnz�9-d �� <br /> LEGA LOTNO. BLOCK r6^,��Z C �2a �`I�f 3 8 -S'yS�{ <br /> DESC. <br /> OW�NER ADDRE55 ZIP PHONE <br /> �C6 % �A�� � �^�%{,C 2 �A�Z <br /> TENANTNAME CONTACTNAME PHONE <br /> �N�� � ?oY ��k <br /> CONTRACTOR ADDFESS 21P CONTR.IICENSE M <br /> PHONE <br /> PROPOSED USE OF BUILDING Building � Mechanicul Addition HEAT SOURCE <br /> PERMIT Combinalion Plumbing WORK RL1 Alleration Electnc <br /> 5 r' ✓�\ I TYPE � Demolitian Sign TYPE u New I � Gas <br /> � Sprinkler U qepair/Malnt. Other <br /> CONTRACT PFICE OF WORK CITV OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> WORKDESCRIPTION �U;. �.� G( }�CI� �+f °�H iV�CD /� /hSPtflf <br /> '�-O/ /�e�yL dvw.t/' //iSv/c�CB . <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR REM NO. TVPE OF FU(TURE OR ITEM <br /> I = WATER CLv3�T = A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWtR UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLO''HES DRYER <br /> , DISHWASHER RAP�GE HOOD <br /> _ LAUNDFV TRAY W4TER HEATER <br /> I = CLOTHESWASHER � MEIAIFiREPLACE/STOVE <br /> URINAL FIpEPLACE INSERT <br /> ' DFINKING FOUNTAIN � GAS FIREPL4CE <br /> FLOOR DRAIN GAS FANGE <br /> , _ BACKFLOW PREVENTER GAS PIPING <br /> �� SINK (SEFVICEiBAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFY'HAT I HAVE READ AND EXAM�NED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF 4tWS 4ND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> N0T THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTPUCT�ON OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNEFl OF THIS PROPERTV TO PERFORM THE'NORN FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE ETATE <br /> CONTPA �j 1B27 R6 .200 WAC. �-� 'O� <br /> Signawre wneuContractouAuthonzed Agem ate <br />