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� �ERMIT APPLICAT�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAA STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.If PERMIT M � <br /> izis ��ib ��� CO c <br /> LEGA LOT O. SIOCK TAACT � <br /> DESC. <br /> OWNER ADDRESS DP PHONE � <br /> F✓c...� k Sl�r�� �'i�IZZ .SD��avcw i41uk�/�� j�1 �- 515z <br /> TENANT NAME COMTACT FOR PERMIT pFpry� <br /> _ � A��.� 5:,�,o,�s ��z5 .�y�-�z�r.s— <br /> COHTRACTOR A��S R��Na�Pc� + Rc�'����ADDRESS ZIP CONTR.UCENSEI <br /> PMONEL��S'�yG.--y2Y5� �U070���tSc,.✓t f�2�� � — <br /> Ats�E�¥��r <br /> PROPOSED USE OF sUILDING Building f'1 Mechanical � AdAitbn HEAT SOURCE <br /> + � � � PERMIT Combination K Plumbing WOHK Alteratlon Elearic <br /> ..��I �,( �, �. , � , TYPE Demolition LJ Sign TVPE New 6es <br /> �� �'` � �' Sprinkler RepaldMaint. pry�� <br /> CONTRACT PRICE OF WORK ,�/�DD CITV OF EVERETT IOCAl1ALES TAK CODE If 7105 <br /> WOpKDESCRIP770N ��q,,r�L w���� �v/ a-- 1 ��JJr ���CId3�✓� a.�^I7✓�� WHS� <br /> rr r.�j-y,r <br /> PLUMBING (NECHANICAL + <br /> N0. TYPE OF flI(TURE OR ITEM NO. TYPE OF FlIfTURE OR ITEM <br /> _ WATER CLOSeT _ q/C—A/HANDUNG UNITS <br /> _ BATHTUB _ FORCED AIR SYSTEMS � <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> _ SHOWER _ UNIT HEATERS <br /> _ KITCHEN SINK&DISPOSAL _ CLOTHES DRYER <br /> _ DISHWASHER _ RANGE HOOD <br /> _ LAUNDRY TRAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSEFT <br /> _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> _ FLOOR DRAIN _ GAS RANGE <br /> _ BACKFLOW PREVENTER GAS PIPING <br /> __ SINK(SERVICE/BAR/MOP/ETC.) Y EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I 1��P.cBY CERITIFV THAT I HAVE READ HND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PR�VISIONS OF IAWS AND ORID�NACES GOVERNING THIS Tl'PE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> S7ATE OH�OCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TNE STATE <br /> CONTRACTORS LAW,1827 f1CW AND 296.200 WAC. <br /> �-� ' 3-2g-o'3 <br /> Signature of OwneU ontractodAuthonzed Agent Date � <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED 1/2' <br />