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�tRMIT APPLICA"tI�N <br /> CITY OF EVERETT PERMIT :SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.�I PERMiT a <br /> `/ � ar �.. 2G, —Evv�++ �U309��S�C7 <br /> LEGA LOiNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �o�wv.n Fui-le.. �J7?/ `,..f�� � • �vc.c.# yzs-2�3 llev <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONiRACTOR��I.w�� � � /)ew� I ADDRESS Z-�Q �� ����C� � ZIP CONTR.LICENSE N <br /> l C ' � <br /> PHONE JT��Wouc� WA q�j252 ac�.w��co�tic3 <br /> 3Go-�39• z.�.3� <br /> PROPOSED USE OF BUILDING I Bullding �MechanlCel Addllion HEAT SOURCE <br /> PERMIT R Combinati0n PlUmbinp WORN �AlteraUon �Eledric <br /> TYPE g Demolillon Sign TYPE New Gae <br /> Sprinkler RepalrlMaint. Olher <br /> CONTRACT PRICE Of WORK � 7Q�� OD + T�K GTY OF EVERETT LOCAL SALE9 TAX CODE IS�106 <br /> J r/v l <br /> WORKDESCRIPTION n��d� + <br /> 5��+, �� F,,M.« � D��- Sysk� _L�,�n µtaT�,� � L�� P•P� <br /> -h ,c��,, �,..4 K .- H,, c r•,,,k('N� Pt�...s,��,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR IiEM NO. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB � FORCED AIR SYSTEMS <br /> IAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> _ LAUNDRY TRAY � WATER HEATER <br /> CLOTHE�WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER ,� GAS PIPING F�rr�c[ r WA}" (�•� <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFV THAT I HAVE READ AN�EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. TIiE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUTATINCa CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZED BV THE <br /> OWNER OF 7HIS PROPERTY TO P T WORK OR WMICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR4CT0 7 7 D 29 . K�A� <br /> �/ � "��`/8-�� <br /> , Sign e of Owned o racW onzed gent ate <br /> ' DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />