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P�r�MIT �►PPLICATIG_�J � <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, Wq gg201 <br /> 425-257•8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# <br /> PERMIT q <br /> t�� i,�.�� z`i��#-laoi o8 mazn4 - o� <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER � AODRESS <br /> 21P PHONE <br /> �LAe-� nr,�'�Q;� ' L�c I c�evEe�,e�c,� tNhY Ev� wq q �Izs-3'�17.576 <br /> TENANTNAME I CONTACTNAME <br /> PHONE <br /> �G'rCLFO Yv1AAJ(F I.l'fcc4_(J <br /> OI�Y('"1 At.lx- M�HAN�'r,,.. `�.(.� AODFESS <br /> �Q p,�X ,�.��� Z�P CONTR.LICENSE M <br /> �i�s-77�(-8t3N( �`/Nt-�wcx�D W� `i8�`fC� �-YMPMSf7.C�Dl <br /> PROPOSED USE OF BUILDING Building I""1 Mechanical <br /> Addilion HEAT SOURCE <br /> PERMIT Combinalion K plumbing WORK Alleraiion <br /> TYPE Demolitian Electric <br /> LJ Sign TYpE New G&.. <br /> Sprinkler Repair/Main1. Olher <br /> CONTRACT PqICE OF WOR o✓ CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � _ <br /> WORK DESCRIPTION <br /> �' R��x.�-r►� G�sPS��� -Co coN�v� T-o }z�:�,<t-TED <br /> GA 5 METkfZ <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIXTURE OR ITEM <br /> N�• TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET _ AIC-A/HANDLI�IG UNITS <br /> � _ BATHTUB _ FORCED AIR SYSTEMS <br /> I _ LAVATORY(WASH BASIN) _ HEAT�UMP <br /> _ SHUWER _ UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> _ D�SHWASHER RANGE HOOD <br /> i _ LAUNDRY TFiAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> � _ UPINAL <br /> _ DRINKING FOUNTAIN — FIREPLACE INSERT <br /> _ FLOOR ORAW — �AS FIREPLACE <br /> _ BACKFLOW PREVENTER — GAS RANGE <br /> _ SINK (SERVICE/BAR/MOP/ETC.) — GAS PIPING <br /> _ OTHER _ EXHAUST FAN <br /> _ OTHER <br /> _ �_ <br /> I HEFcBY CERITIFY'HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. qLL <br /> . PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPUED WITH WHE7HER SPECIFIED HEREIN OR <br /> N07. THE GRAN7ING OF A PERMIT DOES NOT PR�SUME TO GIVE AUTHORITY TO V�OLATE OR CANCEL THE PfiOVI510N OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTNOR�ZED BY THE <br /> OWNER OF IS PROPERiY 70 PERFORM TI1E WORK FOR WHICH APPLICATION IS MADE AND I COM?LY WITH THE STATE <br /> , CO�AC FS L.1W 7827 RCW AN0 296.2UO WAC. <br /> ' � ��/Z-p . <br /> e.of neUContractoUAuthorized Agent Dafe <br />