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�rRMIT APPLICATIvN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRE53 PARCEL TAX I.D.K PERMI7 a <br /> 31� �e IY�o 30� -03 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DES0. �� –� <br /> OWNBR ./.y + ADQRESS ZIP PMONE <br /> Cl� �y O��V�i �4G� � I,� ,3� �7 �'�J�, /b/�(J � — <br /> 17� v <br /> ClNT-1,NAM�,� ���� CONTACT FOR PERMIT PHONE <br /> /y I�c ; l,'fi�e0 ��/,��� A��r �-.« G �7.r��) ' <br /> CONTRACTORI,� /J,�y �,�r J�� ADDRES ZIP ONTR.LICEN9EN <br /> 'r V <br /> PHONE /' ,�_ � <br /> CJ <br /> PROPOSED USE OF BUILUING Building �fI�Mechenical Addltlon HEAT 90URCE <br /> PERMIT B Combinelion B Plumbing W�RK � AlteraUon �Eleclric <br /> TYPE D Demolitlon Sign TYPE New Gas <br /> U Spnnkler Ravalr/Malnt. Olher <br /> CONTRACT PRICE OF WORK 'J/'i O CI7Y OF EVERETT LOCAL SALE9 TAX CODE 18�106 <br /> v <br /> WORK DESCRIPTION � ^ �/V� G �� P �J � ����r <br /> ` nn 1/ L(/�'ti- GY <br /> �n 5 e, � I rl �.��,.rlx- <br /> � ��� : Tvn l,Cw �t <br /> PLUM8ING MECHANICAL <br /> N0. TVPE OF fIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C–AIHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BAS�N) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LPUNDRY TRAY WATER HGATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GA5 FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK�SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER _ <br /> � <br /> I I HEREBV CERITIFV THAT I HAVE READ ANO 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 WITM WHETHER SPECIFIED HEREIN OR <br /> � NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHGRI:V TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br /> � STATE OR LOCAL LAW REGUL4TING CONSTRUCTION OR THE°ERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APP�ICATION IS MADE AND I COMPLV WITH THE STATE <br /> ICONTRACTORS LAW iB.2' RCW AND 296.200 WAC. <br /> _����,� �.��,�%�f,�< 7��n�o3 <br /> I Signa ure of wn ontrac or u h rized Agenl ate <br /> DEB'.T 8 CREOIT CARDS ARE NOT ACCEPTED � <br /> � — - — <br />