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P�RMIT APPLICATIC.�V <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.p yP�ERMiT a (y <br /> LZc7�i ��tS�nuk 5!- C•rn� ,�� 9P �� /I'V��2"� / <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PFiONE <br /> l�� �' a�o����. ��,�d�� �� . �, .,,�.�� �425�25B -04Z,5 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACTOR L�n�50u., WQ, Oc�{,S ADDRESS QqQ � ��(7«` S�- �J W.ZIP CONTR.LICENSE N <br /> �,�,q� � V,/ct 98292 L�NDSSWo91PS <br /> PHONE(3t,o� 652-5858 <br /> PROPOSEDUSEOFBUILDING I TMPEIT �._j Demoll9io`non R S9 bingfll IWOEK R Nt��on HEA� EOl�ctric <br /> U Sprinkler D B Repalr/Maint. <br /> CONTRACT PRICE OF WpRK CITY OF EVERETT LOCAL SALE9 TA%CO�E 19 J705 <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-AIHANDLING UNITS <br /> BATHTUO FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> DISHWASFIER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES W4SHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> � DRINICING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXNAUST FAN <br /> OTHER OTHER <br /> i <br /> j I HEREBV CERITIFV THAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL <br /> � PROVISIONS OF LAWS AND ORiDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WNETHER SPECIFIED HEREIN OR <br /> �� NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br /> � STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERfORM THE WORK FOR WHICH APPLICAiION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW ANO 296.200 WAC. <br /> - ,�,� ;...,% �/>/ay <br /> bignatur�bwner/ContractorlAuthonzed Agent ' ate <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />