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r <br /> ! —i, _ <br /> \ <br /> PERMIT APPLI�ATION <br /> CITY OF EVERETT PEFiMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810- FAX 425-257-8957 <br /> SITE ADDRESS PARCEL TA%I.D.R PERMIT M <br /> 5 I rn o� �G �ozg� <br /> ;�o <br /> lEOA LOT NO. BLOCK TRACT <br /> DESC. O <br /> OWNER ADDRE89 LP PHONE <br /> �J1GCr1 IOi ����A p� �a1� 200� aD��.v� WP 57f041 �y�S�T"Ib�`I5b2 <br /> TENANTNAME I CONTACTNAME PNONE <br /> CONTRACTOR ADDRE88 LP CONTR.LICENSE� <br /> GYv� l� �a��n5 1�1 ►5 (3rond �Qy £u e�t�4-� W R 9t�2n1 Crn Hec�y� oq5�4 <br /> PHON y,�s 25 ' b�PL <br /> PROPOSED USE OF BUILOINO Building p Mechenicel Addiilon HEAT 80URCE <br /> PERMIT R Com6lnellon H Plumbinp WORK � Auereuon �l Eleclrk <br /> TYPE D Demollllon LJ Sign TVPE New D Dae <br /> �> Sprinkler FiepeldMalnt. U Olher <br /> CONTRACT PRICE OP WORK �/� � CRV OF EVERETT LOCAL SALES TA%CODE IS�106 <br /> Se}es��w �� +d4 �.ri�- ;,n plati o� oid q� a l�dd;}�cyn cs� �'► <br /> hCW WG�hn '{�1f R�.v�S � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N�. TYPE OF FlXTURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLINCi UNITS <br /> DATHTUD FORCED AIR SYSTEMS <br /> LAVATORY (WASH DASIN) S HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES ORYER <br /> DISHWASHCR HANOE HOOD <br /> LAUNDRY TRAY _ WATEH HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUN7,^.iN DAS FIREPLACE <br /> FLOOR DRAIN OAS RANOE <br /> BACKFLOW PREVENTER _ OAS PIPINO <br /> _ SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN L <br /> OTHER_ � OTHER I <br /> Yf(lf W\I>1� <br /> I HEREBV CERITIFY THA71 HAVE READ AND E%AMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORHECT. ALL <br /> PROVISIONS OF 11�W5 AND OFIDINACES 60VERNINO THIS TVPE OF WORK WILL 0E COMPLIED WITH WHETHER SPE�:IfIED HEREIN OR <br /> NOT. iHE GRANi1NO OF A PERMIT DOES NOT PRESUME 10 OIVE AUTHOiiI1V TO VIOLATE OA CANCEI THE PflOVISION OF ANV OTHER <br /> STATE OR LOCAL LAW RE6ULATINO CONSTNUCTION OR THE PERFORMAMCE OF CONSTRUCTION. THAT I AM AUiHOfiIZED BV TNE <br /> WNER OF TN1S PROP[RTY TO PERFORM THE WORK FOH WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> NTRACT09S �'�1827 RCW AND 298.200 WAC. <br /> L <br /> i n lure o wner/Conlrectorl ut orize genl ete <br />