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_—� . <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE AUDRESS PARCEL TAX I.D.It PERMiT r 1 <br /> 3/,? C�DrrLe ,ec 7-' -p <br /> LEGA LOTNO. BLOCK TRACT j <br /> DESC. <br /> OWNER ADDRESS ZIP PMONE <br /> C_ /T/ �'J� CvE�'E71'- � <br /> TENANT NAME I CONTACTNAME PMONE i <br /> �f1C/L/��-S �K� t%I�/Y'%e� �7 O O �� � <br /> CONTRACTOR /ry O� �CdfiCE7� ADDRESS ZIP CONTR.LICENSEM � <br /> �AGi!//!LS I <br /> PHONE 2S�J����� <br /> PROPOSED USE OF BUILDING uilding Mechenlcal Adtllllon NEAT BOURCE � <br /> �+ PEHMIT Combinetion lumbing WORK Altarallon Electrk � <br /> �c�/G/TlE.S J�✓OP TYpE Dem011�1On Sign TVPE New R�.j Oae � <br /> Sprinkler(M ol heeds) RepalrlMelnt. LJ Other <br /> CONTRACT PpICE OF WORK 3b p O CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> i <br /> WORKDESCRIPTION � 'au/(O (/� /2� rrS/�y� �QDO/� �/It Dps7L'ettw%CTB�. <br /> ��/YJOdC C/J 70�I.Er't f/NE'� /QE�A1� C/ILlRIUAL �Q.v.O /A'it� P.��enni✓ �,c AD� � <br /> �o6�GSt A2.w..a Toi�c�r. <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR REM N0. TYPE OF!•7%TURE OR REM <br /> �� WATER CLOSET(TO�LET) _ A/C—A/HANDLING UNITS i <br /> BATHTUB FORCED AIR SYSTEMS I <br /> � LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER I <br /> _ DISHWASHER _ RANGE HOOD <br /> _ LAUNDRYTRAY _ WATERIiEATER <br /> CLOTHES WASHER _ METAL FlHEPLACE/STOVE i <br /> �l URINAL FIREPLACE INSFRT <br /> _ DRINKING FOUNTAIN GAS FIREPLACE I <br /> _ FLOOR DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.� EXHAUST FAN <br /> _ OTHER_ _ OTHER <br /> I HERE�Y CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AN�KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINA(:ES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERId1T D06S NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PEPFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI7.ED BY THE <br /> OWNER Of THIS PROPEFiY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE S7ATE <br /> CONTf-F �� Z�i�OWAC. / / <br /> i t7 a3 <br /> Signa�ure oi uwne�ntraclor/Authonzed Agent ate <br /> � __------ <br /> Y� <br />