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1-ERMIT APPLICAT�JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SI7E ADDRESS PARCEL TAX I.D.N P iT x <br /> � _ �, � i1vE ��a3o�l- oa3 <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER AUDRESS LP ����E <br /> /y1/C1�iJ`FL /2C>�.v17.t1 ��1v` �d�a9�/ Evf-�2C�: wA• 9��0/ 9�f-(�,3/� <br /> TENANTNAME CONTACT ORPERMIT � PHONE <br /> cN»i?1.E1' /.��1�� I 7�ANr (�zS)- 2.�9/�2.3- <br /> CONTRACTOR ADDRESS ZI CONTR.LICENSE M <br /> ��tijlf Ce.vJ�tx�T7p.✓ /09Z7 Za—`T�-'�-S.F. 9pzu& c -i M <br /> PNONE �s � <br /> PROPOSED USE OF BUIIDING B�ilding I"1 Mechanical Adtlition HEAT SOURCE <br /> PERMI7 Combination W� Plumbing WORK RI—( A�teration R Electric <br /> IYPE Demolition LJ Sign TVPE �j New u Gas <br /> Sprinkler U Repair/Meint. U Other <br /> CONTRACT PRICE OF WORK CITY OF EVEqEff LOCAL SALES 7A7C CODE IS 3105 <br /> WORK DESCRIPTION <br /> RC->>�.��C- f/�7 w.13�� It�17"� ��i�-r� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF flXTURE OR ITEM N0. TYPE OF FlXTURE OR REM <br /> WATER CLOSET _ A/C—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 /> IAUNDRY TRAY L WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACElSTOVE <br /> UHINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHES <br /> I HEREBY CERITIFV THAT I HAVE FEAD A1JD EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AN�ORIDINACES GOVERNING THIS TYPE OF WORK WIL,.BE CUMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> � NOT. THE GRANTING OF A PERMIT DOES IJOT PRESUME TO GIVE AUTHORIIY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PEFiFORMANCE UF COF.STRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PER RM THE WORK FOR WHICH APPLICATI01�IS Mf.DE AND i COMPLY WI7H THE STATE <br /> CONT S LAVJ . CW A 29 O WAC. <br /> � / r2o3 <br /> igna ure of L� - o r thb etl Agent Date <br /> ; DEBIT& CREDIT CARDS ARE MOT ACCEPTED <br />