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E -7-0 �I <br /> , I <br /> P�RMIT APPLICATIO�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> • 425-257-8810- FlllC425-257-8857 � <br /> SITE ADDR��SS PARCEL TAX I.D.# PERMI7 z � <br /> ��� � LOLr> Y S T i� ���� � 7 �I <br /> LEGA LOTNO. BLOCK TRACT I <br /> DESC. <br /> OWNER ADDRE55 ZIP PHONE '� <br /> /fC L �3 ��- 3/'�� C vc.�3 Y yz�25� C s'S c"�, <br /> r� c U S' � <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CO�ACTOR / ADDRESS ZIP CONTR.LICENSE M � <br /> �GIC C.�J I'i•i!J'l�� i.,.� �t t'/Lc.`c;�i.'lJ�('� o7 �'/Zfl�G'�'ilre5�5'lr/� <br /> PHON i l— C L�D O .c. S �� � �'L I <br /> � �C/� � sC� �f �/ L�l�'��v�- Cl �fYu� w/d �r�° � Z <br /> PROPOSED USE OF BUILDING Building f"1 Me�hanical Addition HEA7 SOURCE ��� <br /> PERMIT Combinalion F_� Plumbing WORK Alteration Q Electnc �il <br /> 7YPE � Demolition L.J Sign TYPE New �...j Gas <br /> Spnnkler Repair/Mainl L� Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 i <br /> WORKOESCRIPT N � <br /> �L'/ai1 a /� � D S� L'-t' /v� /� 9�✓LC/'LUd r �� l ' �1 <br /> s�.�>r� <br /> nw e�- c=r� �- -� -� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ FUC—NHANDLING UNITS I <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES ORYER I <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLr�CElSTOVE ' <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPIACE <br /> _ F�OOR DRAIN �AS RANGE i <br /> BACKFLOW PREVENTER GAS PIPING � <br /> SINK(SERVICEIBAR/MOPIETC.) EXHAUST PAN I <br /> _ OTHER _ OTHER I I <br /> I HEREBY CERI7IFV THAT I HA4E RE1D AND EXAtdINED THIS APPLICATION AND KN01N THE SAME TO BE iRUc AND CORRECT. ALl I <br /> PROV�SIONS OF LAWS AND ORIDiNHCES GOVERNING THIS TYPE OF WORK WILL BE COAIPLIED 6YITH�NHETHER SPEGFIED HEREIN OR <br /> rJOT. THE GRANTING OF A PER�dl7 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE GR CANCEL THE PROVi510N OF ANY OTHER I <br /> � STHTE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I Ah1 AUTHORIZED BY THE I � <br /> � OVJNER OF THIS PROPERN TO PERFORM THE WORK FOR 1VH�CH APPLICATION IS tdADE AND I COMPLY WITH THE STATE <br /> CONTRACTOFS LAW CW D�96.200 WAC. � <br /> i���----- ��? y�! <br /> Signaturo of GwnenContractor/Authonzed Agent Date , <br /> � DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />