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PE��MIT APPLICATIO►� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE AODRESS PARCEL TAX I.D.N PERMi7 M <br /> o C� �s •tl� DSG>�- 395-Dac-,c�v [3c�� <br /> LEGA 1O7N0. 8pLOC T�ACT �,C�/ts � 3 <br /> DESC. //{ •f'� � 7f /� I N <br /> O NEF ADDRESS ZIP PHONE <br /> �6y �w,�c. /9/0 Y�/fsr�lwr �d.�,,�tt' 4�'�0� ��" Zs'9-/9// <br /> TENANT NAME I CONTACT NAME VHONE <br /> CONJRACZQp A_ 6J_ _1_�, PLQ15 �` /�� ZIP CONTR.LICENSE N <br /> 5�-{� [�d►f 7fGt�ii�--� � 7 I.J <br /> PHONE �r/���� �/q� �IZ3I S� I�I �� <br /> PROPOSED USE OF BUILDINO Building f7 Mechanlcat Addiiion HEAT SOURCE <br /> I PERMIT Combinelion �_� Plumhing WORK niieraiion [� Electrk <br /> TYPE � Demolilion L! Sign TVPE � New I �] Oas <br /> l.I Sprinkler Repeir/Meint. LJ Other <br /> CONTRACT PRICE OF WORK ��0� Clri OF EVERE7T LOCAL SALES TA%COOE IS 3f05 <br /> WORK DESCHIPTION <br /> 1�E �c� — F"12�:c�7 t��,c/� � <br /> � �l/ � — �,�p,��� �c.�+.��'c� axn�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> WATER CLOSET _ AIC–A/HANDLING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDFY TRAY WATEF HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN �AS FIREPLACE <br /> � _ FLOOR DRAIN _ OAS RANGE <br /> � _ BACKFLOW PREVF_NTER _ GAS PIPINO <br /> � _ SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> i OTHER _ OTHER <br /> i <br /> I — — <br /> i <br /> � I HEREBV CERITIFY THAT I HAVE REA�AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TPUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS ANO ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> iNOT. THE GRANTING OF A PER1dIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OP THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BV THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br /> i CONTRACTORS LAW 18. CW AND 298.200 WAC. <br /> � <br /> ; �� ��� <br /> � S��nalure ol OwneU nlracTorlAuthonzed Agern ate <br /> � <br />