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P�RMlT APPLICATI� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WF,98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS !�U/GL��^�? PARCEL TAX I.D.# PERMIT# <br /> - � � r n �' - ��T o.s�(��o ' GY,t� <br /> LEGAL LO'NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> C-�y /%�n y� ��iC �S �i'a v/-' <br /> ENANT NAME QJ�/i�,E.' ,Q(f�_ CONTACT FQR PERMIT PHONE <br /> 1�� ' � � � ,� 7�9-0/7S <br /> �' r -���f����<<�� � ,_ <br /> CONTR CTOR ADDRESS ZIP . CONTR.LICENSE# <br /> PHONE <br /> PROPOSED USE OF BUILDING Building (7 Mechanical Addition HEAT SOURCE <br /> PERMIT R Combination F_� Plumbing WORK � Alteration � ElecVic <br /> TYPE D Demolition Ll Sign TYPE New Gas <br /> U Sprinklef Repair/Maint. Other <br /> CONTRACT PRICE OF��ORK /7 CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> C, /� <br /> WORKDESCRIPTION /���%C �j�'r�� /�� ` /��� <br /> G G [, i'i �.J G� <br /> PLUMliING T MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM I NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB i FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOW[R UNIT HEATERS <br /> KITC:HEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNQRY TRAY WATER HEATER <br /> CLOTHES WASHER METALFIREPLACE/STOVE <br /> URINAI. FIREPLACE INSERT <br /> DRINKIIJG FOUNTAIN GAS FIREPIACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOIV PREVENTER GAS PIPING <br /> SINK(SEP,VICEIBAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> � ; HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> IPROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR I <br /> NOT. THE GRANTING OF A PER�11T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOi.1TE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TH/+T I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLIC4TION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR4 f�S LA�18.27 RCW AND 296.200 WAC. <br /> ; �i,���, �//��� <br /> � Sign Owne ontractdr uthonzed Agent ate 1 <br /> I DEBIT & CREDIT CARDS ARE NOT ACCEPTED ''Z <br />