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��5 <br /> � -- --- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl i, WA 98201 � <br /> 425-257-8810- FAX 425-257-8857 �� �b- _ d( r) <br /> � <br /> SITE ADDRESS PARCEL TAX I.D.# I P RMI7 R <br /> " � UO c�1hOl'1 Do$OD I � `-�p? 'Olb <br /> LEG.4L LOTNO. BLOCK TR,(JACT <br /> DESC. ! C� �Up z <br /> OWNER ADDRESS ZIP PHONE <br /> �E���f�i��s:sl'rti�$ I,l.� 3307 r�N�� a,v� �.�.,�w�i �.1�-�,Y�2v�— <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �/ID �afu�f.K ��-Z5 Z-(,�,�.�:- <br /> CONTRACTOR 1 � I ADDRESS ZIP CONTR.LICENSE# <br /> ��,lN C-l�n� `���[,�ION <br /> PHONE <br /> �Z.s-3�3- �a7lo �O,��XLI ��' �I'd27s (3aL�rd�1'�ZLD <br /> PROPOSED USF �F BUILDING f, Building f'l Mechar�ical Addition HEAT SOURCE <br /> PtRMIT F{�-( Combination �_� Plum�ing WORK Alteration �I-1,( Electnc <br /> 1YPE �j Demolilion L/ Sign TYPE New Y�Gas <br /> ����_ U Sprinkler Repair/PdainL LJ Other <br /> CONTRACT PRICE OF WORK � ��� �G'J CITY OF EVERETT LUCAL SALES TAX CODE IS 3�05 <br /> WOkK DESCRIPTION <br /> /�G�1�� FJ�-�ic-� �,. � ��1�-�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> 9ATHTUB FORCED AIR SYSTEMS <br /> IAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SIIVK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLO'�HES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICEIBAR/MOPfETC.) EXHAUST FAN <br /> OTHER OTHER <br /> II HERE91'CERITIFY THAT I HAVE READ AND EXA6�11NED THIS APPLICATION AN�KNOW THE SAME�t0 BE TRUE AND CORRECT. ALL <br /> I PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS Tl'PE Or N'ORK WILL BE COMPIIED WITH WHETH'tR SPECIFIED HERtIN OR <br /> � NOT. THE GR.4NTING OF I',PERM1dIT DOES NOT PRESUD�fE TO GIVE AUrHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> � STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR TNE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY 70 PERFORM THE VJORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE I <br /> I CONTRACTORS LAW 78.27 C � ND 9fi200 WAG. <br /> � <br /> Siana re o Ow r/Con actodAw onzed Agent Date <br /> fDEBIT & CREDIT CARDS ARE NOT ACCEPTED �� 31�`� � `l� I <br />