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�_`.� � <br /> � P�RMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES ;� �i <br /> 3200 CEDAR STREET, EVERETf, WA 98201 I I <br /> 425-257-8810- FAX 425-257-8857 <br /> i ii <br /> SITE AD�RESS PARCEL TAX I.D.# PE iT# i li <br /> 3�,�01 � l � - <br /> LEGA OT NO. 8 TRACT i <br /> DESC. �����7 ��� <br /> OWNER ADDRESS ZIP PHONE ���� Qj_.��.- <br /> ��ne ���� (t�%Fr� lJ.�, Pn.��x S�� 9g2� �v��� <br /> TENANT NAMC- CONTACT FOR PERMIT PHONE i <br /> �ACTOR, � ADDRE S ✓ ����� ��AI�.�✓J yYTI��� <br /> ZIP CONTR.LICENSE# <br /> �1air� lU5�q- 2��2 ��J��rn� �E l3c�►��cn��.a <br /> PHONE� 7 (Z „1/ • ''ln lLJti.�i <br /> � 7 r dx_I 7 t4,I7 /�xL10 <br /> PROPOSED USE OF Bl11LDING Building Mechanical I Addition HEAT SOURCE <br /> PERMIT � Combination Plumbing WORK � Alteration I7 Etecinc <br /> ttPE Demolilion Sign 1'YPE New � Gas <br /> Spnnkler REpair/MainL Other <br /> CONTRACT PRICE OF WORK �� 'j;"y'� /'�/1 � �`�' CITY OF�VERETT LOCAL SALES TAX CODE IS 7105 � <br /> c.1�v l/L l <br /> WORK�ESCRIPTION +�VAG 5«`�"t�: /N5i1w TWJ T4u�7iN�y(, Rf�If�T L3�'�F� Nir7� JItSFt�yf�[o j,r��TwriC� <br /> rL�.�n7D:N4 j���'L� /N�l�N�- ONL /M�vJ si.vlC , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF fIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> I <br /> _ WATER CLOSET(TOILET) _ A/C-A/HANDLING UNITS I <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAI. FIREPIACE INSERT <br /> DRR:KING FOUNTAI� GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENiER GAS PIPING <br /> / SINK(SERVICE/BAIZ'MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> _ — — I <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUt AND CORRECT. ALL � <br /> PROVISIONS OF WWS AND ORIDINACES GOVERNING THIS TVPE OF WORK 11'ILL BE COMP�IED 4VITH WHETHER SPE�IFPSD HEREIN OR <br /> NOT. TME GRANTING OF A PERAIIT DOES NOT PRESUME?0 GIVE AUTMORITV TO VIOLATE OR CANCEL THE PROVISION OF AWY OTHER ' <br /> STATE OR LOCAL L4W REGULA7ING CONSTRUCTION OR THE PERFOR6IANCE OF CONST,2UCTION. THAT I Ald AUTFORI'<ED�Y THE � <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK POR WH�CH APPLICATION tS�dADE AND I COMPLY WITH THE STATE ' <br /> CONTRACTORS LA'N 1 7 RCIV AND 296200�1'AC. � <br /> I I <br /> /�—� S' !Y :Y � <br /> Signature wnevContractor/Authonzed Agent ate <br /> I <br /> � � DEBIT � CREDIT CARDS ARE NOT ACCEPTED I <br />