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. , <br /> � <br /> �PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT 5ERVICES <br /> 3200 CEDAA STREET, EVERETT, WA 98201, 425-257•8810 <br /> SITE ADDRESS PARCEL TAX I.D.� PERMIT N <br /> � �/ t `I C (cN"�tM�} �� G�SiGgs3i � ti9uo IJ -C�� <br /> LEGAL LOT NO. BLOCK TRACT /�,,�� p <br /> DESC. �,�1— � � 1 � 1 T�tfE /i�T�'v .( ��`f/� l ��/�i0� <br /> tlWNER �I.ILHACEI Giii;STRUCT ON ADDRESS PHbNE <br /> 2132 ftIGli' AI:D AVG. y�J t s i �yfo <br /> ['�'CRCT'I dP"f1 94201 <br /> TENANT NAME f CONTACT NAME PHONE <br /> I <br /> CONTRACTORNALBACH COIJSTRffCTIOf� � ADDRESS I CONTR.IICENSEN <br /> � <br /> .^,132 FIICIiI,AI�D A�'C. �✓/� 1��� � L30u/� <br /> PHONE EVERGTT, WASti. 9G201 � <br /> PROPOSED USE OF BUILDINO � Bullding n Mechanical nddiuon HEAT SOURCE <br /> PERMIT Com6ination ❑ Plumbing WORK �Alte�auon D Eiectric <br /> TYPE Demolitlon � Sign TYPE New � Gee <br /> Sprinkler Repelr/Maint. D Olher <br /> CONTRACT PRICE OF WORK � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION � <br /> va��� � <br /> g� o MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FlXTURE OR ITEM <br /> �✓ WATEF'CLOSET A/C-A/HANDLINQ UNITS <br /> '✓ BATHTUB T FORCED AIR SYSTEMS <br /> L �p,VATORY(WASH BASiN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS , <br /> T KITCHEN SINK 8 DISPOSAI _ CLOTHES DRYER <br /> � DISHWASHER RANGE HOOD `' <br /> LAUNDRY TRAY � WATER HEATER <br /> � CLOTHES WASHER _ METAL FIREPLACE/STOVE h <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN � QAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � DAS PIPING j <br /> SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> Z OTHER ���.���� _ OTHER <br /> I HEi7EBV CERITIFY THAT I HAVE READ AND E%AMINED THIS APPLICATION ANO HNOW THE SAME TO BE TRUE AND CORRECT. AI.L <br /> PROVISIONS OF IAWS AND OFlIOINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT�OES NOT PFESUME TO GIVE AUTHORITV TO VIOL4TE OR CANCEL THE PROVISION OF ANY GTHER <br /> STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PEPFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BV TI1E <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITM THE STATE <br /> CONTRACTOFlS lAW 18.27 fiCW AND 296.200 WAC. <br /> -�� �''�C� � � • 7 -v ti- <br /> ��.„�-• Y � ` <br /> Sig ature af OwnedContrecbdAuthonzed AgeN �818 ��z'J <br />