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P�RMIY QPPLICATION <br /> CITY AF EVERETf PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 e <br /> 425-257-8810-• FAX 425-257-8857 <br /> SITE ADDRESS PAiiCEL TAX I.D.N PERMIT M(�O 1� O �O 1 <br /> I t '-i Ev � �. �'++a <br /> LEGA LOT NO. �;BLO�CK,� TRACT <br /> DESC. , OO <br /> OWNER ADDRESS ZIP PMONE <br /> �M6.L �Sc.o �yd'` Arc N.E . S,,;t� lo0 9Qoo5 �iaS'�� i��� <br /> TENANT NAME CONTACT NAME PHONE <br /> GurVRs ���ss o�. �-�.ve�t�uw,_ _ �o(o � qlo�3 <br /> CONTRACTOR ��pr.�.�Wp� (,�y�s}, ADDRESS ��j� )yph ,�LN� LP CONTR.UCENSEN <br /> 9 g op 5 1V oR'�'H GG�Sl.'q( <br /> PHONE �-I'a�`j' '}GI�.. I�'a�Q <br /> PROPOSED USE OF BUILDING I � Building � Mechanical � Addition HEA�OURCE <br /> PERMIT Combination Plumbing WORK Alteration Electric <br /> TYPE Demolition Sign TYPE New � Ges <br /> ���'hl.SS � Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK ��7j� OQ') CfTY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> WORKDESCRIPTION Tthra�k ZmQTVJ�(�yy�Vr�� C� Itia� t�, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTUHE OR REM NO. TYPE OF fl%TURE OH REM <br /> L WATER CLOSET _ A!C—A/HANDIING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> _ IAUNDRY TRAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIFEPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> _. SINK(SERV�CElB.�R/MOP/ETC.) _ EXHAUST FAN <br /> OTHER_ _ OTH�R <br /> I HEREBY CERITIFY'HAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORflECT. ALL <br /> PROVIS!ONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PHOVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SiynaWre of OwnedContractor/Authorized Agent ate <br /> %L <br />