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F�RMIT APPLICATIVN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEFETT, WA 98201 <br /> 425-257•8810- FAX 425•257-8857 <br /> SITE ADDFESS PAqCEL TAX I.D.1 PERMiT M <br /> (�n= 1' ��., ,�.o �� oso C�3oa-(�Uf� <br /> DESC. �07 N0. L BLOCK TRACT ' w�� <br /> SP �5' - � <br /> ��OWNER ADURE53 ZIP PHONE <br /> K��,Ira�r f_��� , 1'7�31 3S'�`' w✓t, SF- ($�}�l.�II wa NFf�l2 �I2S •y`IS • �� �� <br /> TENANTNAM: I CON7ACTNAME PHONE <br /> . L��v� L�s31�,,� ��2s� ���3- �7�� <br /> CONTRACTOB <br /> ����� ��- ADORESS I-�U3 Z 3 S���y� SE LP CONTR.UCENSE� <br /> PNONE �rZ.s- �`r:; . �7 �g '3at�ll wa. a�t.at �QflNLRe�.oa� e.1 <br /> PROPOSED USE OF BU�IDINO I Building Mechanicel Addlllon HEAT 80URCE <br /> PERMIT g Combination � Plumbing WORK � Atleratlon �Electric <br /> s r �� fl'PE D Demoliti0n SIBn TYPE New Oee <br /> U Sprinklar iiepalr/Meinl. I Other <br /> CONTRACT PRICE OF WORK CITV OF EVERETT LOCAL SALES TA%CODE IS J706 <br /> WORK DESCRIPTION _ <br /> �.J I � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR REM NO. TYPE Of FI)(TUpE OA(TEM <br /> " WATER CLOSET <br /> � �h �, BATHTUB -�- aC-A/HANDLING UNITS <br /> i '�'� LAVATORY (WASH BASIN) _..L FORCED AIR SYSTEMS <br /> ! SHOWER � HEAT PUMP <br /> � � KITCHEN SINK 8 DISPOSAL � UNIT HEATERS <br /> i� � CLOTHES DRYER <br /> I OISHWASHER RANGE HOOD <br /> !� LAUNDRV TRAY � WATER HEATER <br /> � CLOTHES WASHEF � METAL FIREPLACE/STOVE <br /> � UFINAL S? FIREPLACE INSERT <br /> �` DPINkING FOUNTAIN <br /> '� FLOOR DRAW .� 4A5 FIREPLACE <br /> T BACKFLOW PREVENTER —_L (3AS RANGE <br /> �� SINK (SERVICE/BAF/MOP/ETC.) � GAS PIPING <br /> � OTHER _ 9� EXHAUSTFAN <br /> _ OTHER <br /> I MEREBY CERITIFY 7HAT I HAVE READ AND F,XAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AI.L <br /> PqCVISI0N5 CF U1W5 ANO OFI�INACES GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEPEIN OR <br /> NOT. THE GRANTING OF A PERMIT DQES NOT PqESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PHOVIS�ON OF ANY OTHER <br /> STATE OR LUCAL LAW REGULATINO CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAi 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTV TO PERFORM THE WORK FOR WHICH APPIICATION IS MAOE AND I COMPLI'WITH THE STATE <br /> CONTRACTOiiS LAW 18.27 RCW,AND 296.200 WAC. <br /> , , / � <br /> . ; , ! , f '- - � - 30 -. �-3 <br /> SignaWre of OwneVConlractari uthonzed gent ��e ^ i <br /> -- �U � � �r�'� i ��oZ. <br />