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. - ( ( <br /> PERMIT APPLICATION , <br /> CITY OF EVERETT PERMIT SERVICES �-��r;��; ) <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 � <br /> SITE ADDRESS PARCEL TAX I.D.M PE IT# <br /> oG33 Fv� cee� - S. �Y��12�{�.263200 3/Z -C�/ <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. Z <br /> OWNER ADDRESS LP PHONE <br /> �IV�- ��L�� �biC�33 .�v�t'yc�e�.wv�S qc'�v� y25=34fs'-31�{ i <br /> �ENANTNAME � I �� CONI CT�ORPERMIT �/�_ ��lj P (��� I <br /> ,a�v►uT��-� o w�ye„� �� ( i. ,�..�� �_ � ' <br /> CONTRACTOR ADDRESS 21P CO�TR.LICENSEt <br /> v�tS�-.;.0 wY Sou4� Q1� <br /> P"°"��,5,��32�— � IJ�1tz��i��-U�� l✓f� �73 �'e�-v� <br /> PROPOSE�USE OF BUILDING � Btlildi0g n Mechanical I n AddlUon I HEAT SOURCE <br /> PERMR Combinalion j} plumbing WORK f"S pJteraUon Electric <br /> ���� �T TYpE Demo�ition �<<Sign TYPE jpE New Gas <br /> Sprinkler ` lJ RepairlMainL OMer <br /> CONTRACT PRICE UF WORK ��"�� CITY OF EVERETT LOCAL SALES TAX CODE IS NOS <br /> � <br /> woR�{`t,�pnoy _ S l 2S �� c <br /> .� � l x � x �I tiPd - 5��� �— n�,- til��,,��,��� �i�e������ s-� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C—AIHANDL�NG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY _ WATER HEATER <br /> CLOTHES WASHER METALFIREPLACEISTOVE <br /> URINAL FIREPLACE�NSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICEBAR/MOPIETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYP[OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LA\N REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PRUPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br /> CONTRA�TORS LAW 18.27 R�AND 296.200 WAC. <br /> (�,c.e-� `�,;t` l 2- �.—c� "� <br /> Signature of OwneqCo rectorlAuthonzed Agent Date �/Z <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />