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_ . �r r <br /> PERMIT APPLICATION . <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.# PE MI7• <br /> 2� I�a Gv L0`j RYE_ �io 44�' - 5b.'�-Gt�$-ao � /J7� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> P��a�eY ��A��,�.r: Zc%- �Sz-�3�o <br /> TENANT NAM CONTACT fOR PERMIT PHONE <br /> SE�zo<<,'S - �r�ar,� r�u�e5 I KE�ir11'fiA i�1�w5 Z 5 3 -p,o�l � 0 737 I <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSEt <br /> PHONE �I�1 /l^ �(��5� �Q�i�'IUN.c�� <br /> L <br /> PROPOSED USE OF BUILDING 6uildi�g n Mechanical Addi�ion HEAT SOURCE <br /> `�NG� l�/C/� � PERMIT � Combination I"1 P�umbing WORK R Alteration � Eleqnc <br /> TYPE DemOGliOn p Sign TYPE New Gas <br /> Sprinkler B Repair/Mainl. Other <br /> CONTRACT PRICE OF WORK �j���G�O CITY OF EVERETT LOCAL SALES TAX CO�E 151105 <br /> WORK DESCRIPTION <br /> T�Nr.Hr I ;�tv�.����acu�- � P�iv.nn� �x�rr,�c si'.e-cfi t�� S��s,s.a�.�.�c�� <br /> .—xr� T6�YAH'T <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATIiTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTIIES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEISTOVG <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPIACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOPIETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I <br /> I NEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SANE TO BE TRUE AND CORRECT. ALL <br /> PROVISIOIJS OF LAVJS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL 8E COMPUED WITH WFiETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A F'ERMIT DOES N0T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STAT[OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMnNCE OF CONSTRUCTION. THAT I AM AUTHOf212ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FCR WHICH APPLICATION IS MADE AND I COMPLY WI7N THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br /> SignaWre of Owner/ContractorlAuthonzed Agent Date <br /> DEDIT 8 CREDIT CARDS ARE NOT ACCEPTED /Z <br />