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a�z� <br /> PE�r�MIT APPLICATIO�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAJ:I.D.# PERMiT# <br /> 'I > /' co - Q�'" ZZ <br /> LEGA LOTNO BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br />� �quC G�ARD�ER Is( ;'s w !"lul�, 3� Vp '-fZs 7sy z- s�! <br />� TENANTNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR C/C��Y%�� FZ(/YU(LCC'a7L�r/x� ADDRESS /�(1,/3tJ,�'/G-02 ZIP CONTR.LICENSE# <br /> �e��.x�sf,ui� gs:�si ����Tr�-aadew <br /> PHO�iE ;3G'U-SG��":'�)�5 ���L�/�G <br /> PROPOSFD USE OF BUILDR7G Building Rs Mechanical Addition HEAT SOURCE <br /> PERMIT B Combination F�� Plumbing WORK R Alteration �Electric <br /> TYPE D Demolition LJ Sign TYPE D New Gas <br /> U Sprinkler U Repair/Maint. Other <br /> COMTRACT PRICE UF WORK �D�000 �-dO�C�00 ^ CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION /�S���C. C`�� 3 5�0�1. (� CC S �lL�-CL/UfS� (�L(1(�.��+�1j�.C� �u-S'f���itCl f� <br /> �/CA�771l,, J / <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—AIHANDLING UNITS <br /> BATHTUB 1 FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> S'rIOWER � UNI?HEATERS <br /> KITCHEN SINK&DISPOSAL CL07HES DRYER <br /> DISHWASHER FtANGE HOOD <br /> LAUNDRY TRAY i 1VATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STONE <br /> URINAL 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 OTHER <br /> I HEREBY CERITIFY THAT I HAVE REA�AND EXAMINED THIS APPLICATION AND KNOW T'iE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUAfE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �xa..<b� �a16� �� d F <br /> SignaWTA of Own ohtractor/Authonz�d Agent Date �/ <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED L <br />