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P[ �MIT APPLICATIC� J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8870-FAX 425-257-8857 <br /> SITE A�RESS �� PARCEL TA7(I.D.I I pG�iM1T M � �/ <br /> G `J �'ti U., ,,� � <br /> LEQA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AODHESS LP PMONE <br /> I„��o���y , � I ��..�.s� ��.�S a I R� S�c 4.25�SS-a�� 3 <br /> TENANT NAME �J CONTACT NAME PHONE <br /> I �i .0 `1�-� �/1e� .25-3�� -(07 <br /> COMTRAC70R��� � �wh y� ADDPE59 LP CONTR.UCENSE� <br /> � � 4oa� su-.Gys� <br /> PNONE � _ � � , � $'vi � IP C/A�/O C1.�l.Ll�'�4-094�- <br /> PROPOSED USE OF BUILDINO Building Mechanicel AddiUon MEAT 80URCE <br /> PERMIT Combinetion umbinp WORK B Alleretlon D Electrlc <br /> TVPE DBmoIitlOn �gn 7YPE B New U Qey <br /> Sprinkler Repelr/Melnt, L� O�her <br /> CONTRACT PRICE OF WORK �O ;y� CRY OF EVERETT LOCAL SALE9 TAX COOE 18 J706 <br /> WORK DE9CRIPTION <br /> C�.�� 1 ,ke � �o-�..�-�,,7�` 1�a-o,.� n1�� Z. '�}�� , `i 3 ' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM NO. TYPE OF Fl1fTURE OR ITEM <br /> _ WATER CLOSET _ A/C—A/HANDLINO UNITS <br /> _ BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUf.1P <br /> _ SHOWER _, UNIT HEATERS <br /> _ NITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> _ DISHWASHER _ RANOE HOOD <br /> _ LAUNDRY TRAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METAI FIFEPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> _ DFINKING FOUNTAIN _ �AS FIREPLACE <br /> _ FLOOR DRAIN _ QAS IiANQE <br /> _ BACKFLOW PREVENTER _ OAS PIPINO <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> � OTHE� htti�x� ���v,� _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND E%AMINED THIS APPLICATION ANO KNOW TNE SAME TO BE TPUE AND CORRECT. ALL <br /> PROVISIONS OF WS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLiFO WITH WHETFIER SPECIFIED HEREIN OR <br /> NOT. THE NTING OP A PERMIT DOES NOT PRESUM[TO GIVE AUTHORITV TO VIOLATE OR C.ANCEL THE PROVISION OF ANY OTHER <br /> STA7E O OCAL W REGULATING CONSTRUCTION OR THE P:RFORMAIICE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNE F THIS OPERTY ERFORM THE WORK FOH WHICH APPLICATION IS MADE AND I COMPLY WITH THE STAiE <br /> CO �C� W 18.27 C AND 288.200 WAC. <br /> / // Q�_ — .O Z <br /> ignalure o wner! o ractod uthotlze gent ele <br />