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P�RMIT APPLICATIC.�� <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAA STREET, EVFRETT, WA 98201 <br /> 425•257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.N PERM'�� <br /> . � � c � RD tuERcTi ,�f�an3 -rAq <br /> LEGA LOTNO. BLOCN TRACT <br /> DESC. <br /> OWNER AUDRESS 21P PHONE <br /> ���ii✓v�,� ihc/ta� P. ,'�, ��n� tu� ,� � c�E,aEF � y25 9Y >>F <br /> � RE�'EE,t) u /�i��?c .i� ,�n Ya�oc � �� � <br /> TENANTNAME CONTACTNAME PMONE <br /> �✓bn.'E [.H�Ry Gn.vIP � 3�e� GSB' Sti E/ <br /> CONTRACTOR AODHESS LP CONTR.LICENSEN <br /> MARyS����'� �-CREM/Cez/o,� <br /> PHONr�6� ) GSy -S�Gi 6s�� .�7YH O�' .�c Ct�J 9B�z�o <br /> PROPOS[D USE OF BUILDIN6 � Bwlding Alechanicel Addi�ian HEAT SOURCE <br /> �p�� I PERMIT CPmbination F'Iumbing WORK �AIIPralion � F:lectnc <br /> �F/�.r� L_ � �JQ TYPE Demolilion � `iign ITYPE New Oes <br /> S rinkler Re airiMeinl. I Olher <br /> CONTRACT PRICE OF WORK 3�p , p� CITV OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> WORK DESCRIPTION <br /> C�ll�in�GE oG� T wA T'�� 11ts� T,�� u�� 7'N ,�iK,E.. <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF FI%TURE OR ITEM N0. TVPE OF FI%TURE OR!TEM <br /> I <br /> . WATER CLOSET _ A/C—A/HANDLING UNITS <br /> I = BATHTUB = FOFCED AIR SVSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWEfi UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> i DISHWASHER RANGE HOOD <br /> � LAUNDRV TRAY WATER HEATER <br /> CLOTHES WASHER METAIFIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> I _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> I _ BACKfLOW PFEVEVTER _ GAS PIPING <br /> SINK�SERVICE�BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER _ OTHER I <br /> u.'A �rt f1EA•rE.e <br /> I — — — <br /> I HEREBV CERITIFY 7HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TFUE AND CORREC7. ALl <br /> PFOVISIONS CF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT THE GRANTING OF A PERMIT DGES N0T PRESUME TO GIVE AUTHOFITY TO VIOIATE OR CANCEL THE PROVISION OF ANV OTHER <br /> STA7E OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFOHMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THiS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTO � LAW 18.27 RG AND 296.200 WAC. <br /> T`V " ` <_ �-I�-G�2 <br /> Si lure wneU ontractorlAul#orized Agent at�— <br /> i <br />