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� PERMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADORESS <br /> PARCEL TA%I.D.N PERMIT M I <br /> �09 EaS� .�-�•S�Nn nCa4t� 00,�8� QOooO /� � � ' <br /> LEGA LOT NO. BLOCK TRACT L✓� � Ap n Thn c�1�.$ <br /> oesc. , � 3r 3' Ts/v n� 4/� A ''n' `� <br /> OWNER <br /> ADDRESS ZIP PHONE <br /> E�ty� �nveS�rn�e.1.�,J.,� Po./3�� ly3�o Sc� �e 9�109-13�-0 �-2�b 33 <br /> CONTACTNAME PHONE <br /> TF.NANTNAME f,( �� I � �a^q o/ <br /> ��iy /�cic��� '!UlCY) -ThC. KI✓h �e�j4Y.$� Qr� nc �j y�,S'�o72 - .?Ol� <br /> Cgqr HACTOR ADOHESS ZIP CONTR.LICENSEOM'�f <br /> I�ancly �e, ���/ CoNS�ruc.��� (?o.4ox y��l Sc�h��s�,WA 5�az RAaoY�R <br /> PHONE ��,_ 799 � 9�°a <br /> � — <br /> PROPOSED US/E�OF BUILDING Building R MechaniCal Adtlilion HEAT SOURCE <br /> QG�'��p rvr ��SSP.rf�,� PERMIT B COmbinalion �...j Plumbing WORK Allerallon E�leStric <br /> 4Ma a�sp�+��+ o� � TYPE g Demolillon L> Sign �PE qepatrRda�nt. � Other <br /> Sprinklar <br /> {p r a �' <br /> CONiRACT RICE OF WORK .�'^ r� GA�� CITV OF EVERETT LOCAL SALES TA%CO�E IS 3105 <br /> ol g�1 <br /> WORKDESCRIPTION Cdn.SfYvc7 o7N �� O� ���a"✓ C�en1/S�M GJR��,^ �Ov1S <br /> o f e �e nr o v-t- S�S /�F e� �'X'S� /� <br /> �o,rd ,y� AD,A r S ,-'� �rs . �;� /F o� <br /> L k(( rK c��,� y�hcl�4sy�,n�eyr`(cd�,.,� N� HI//+c_ �9�°��s,l „eIOG4�/e - <br /> �� e ' MECHANICAL <br /> PLUMBING <br /> NO. TYPE OF FIXTURE OR REM N0. TYPE OF FIXTURE OP REM <br /> WATER CLOSET _ A/C-AIHANDLING UNII'S <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATCf�Y(WP.SH BASIN) HEAT PUMP <br /> � SHOWER = UNIT HEATERS <br /> KITCHEN SINI:8 DISPOSAL CLOTHES DRYER <br /> � ISHWASHEP RANGE HUOD I <br /> _ �NDRY THAY WATER HEATER <br /> CL HES WASHER _ METAL FIREPLACE/STOVE I <br /> — UFIN�y _ IREPLACE INSERT <br /> � DPINKINb.FOUNTAIN _ a FIREPLACE <br /> FLOUR DRA�N, _ GAS ANCsE <br /> � _ BACKFLOW PREV,�NTEF _ GAS P NG <br /> SINK(SERVICE/DA�t1MOP/ETC.) _ EXHAUS AN <br /> OTHER _ OTHEF <br /> i — — - <br /> iI HEREBV Ce71TIFY'HAi I HAVE READ AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE.4N0 CORPECT. ALL I <br /> pqOVISIONS OF IAWS AND OfiIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> SO TE OR LOCALIIAW REGULA NG CONS RUCT ON OR THE PERPORMANCE OF CO STR CT ONNCTHAT I AM UVTMIORIZED BV THFHER <br /> OWNER OF THIS PROPERN TO PERFORM THF WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAC RS LAW iB27 ii AND 298 00 WAC. <br /> a� ._. . �� S a`'�"°� � <br /> I ignawre OwneuComractor/� t onzed Agent <br /> e�a 'L <br /> � <br /> � _ <br />