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PERMIT APPLICATION <br /> CITY OF EVF_RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRESS , � PARCEL TAX�.D.# PERMIT# <br /> ;:,�5�' ���„��,i-r`,�' ;�r-�- ( 50� "� <br /> LEGAL LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS LP PHONE <br /> ', i <br /> � iCl (� i1f�AT 1��� �i��� viC��;i7ii�1 ��Y 1�?�.'!�7' l��� �f��Of � �� � 9�3 - �^'G <br /> TENAN7 NAME CONTACT FOR PERMIT � PHONE <br /> �-�iLf � �l�rr' (/'/'jY ��' � ��-�F�. ���,:,�,�t�,' �WiG�'� l�!7fl ''�; - �',)p� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSEi <br /> � �,r �' ��r;-�i;^1 ^o.� _ �yo�'�� �'F �'F-�c� � -� p�t�SS3 C��'�) <br /> �������f�'.�i ;ri ��°; r. F jl"JS <br /> PHONE i�':1�:�"uUi� �P �J°.1iF-SF. .,,_i=i� ;'1 <br /> 14�:�� �`t,'; -�J��`: i <br /> PROPOSEOUSEOFBWLOING � Blllldiflg MecFanical Addj60n HEATSOURCE <br /> PERMIT Combination PW�ibing WORK (Allc•ationj Electdc <br /> I NpE molilion � Sign TYPE � New � Gas <br /> S�inkler' RepairrMaint. Other <br /> CONTRACT PRICE OF WORK (� ^t,J CITY OP EVERETT LOCAL SALES TAX CODE IS]f 05 <br /> /�'� 'v <br /> WORKOESCRIPTION _ `� � - _ �� , _. � . - <br /> "�i�r)/"���l�ti�r�l,' '7�) ;%��,S,_ :i �. r-si'�' �i f( ������`- '� S �"•.1i/!/ ) <br /> �'.✓�;'��� � <br /> r <br /> _� '✓ �ji`�i/i��,r�J[� iJ�/ ✓1 %��/ � <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATERCLOSET _ AIC-AIHANDLINGUNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> I SHOWER _ UNIT HEATERS <br /> I _ KITCHEf!SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> � — WATER HEATER <br /> LAUNDRYTRAY — <br />- II = CLOTNES WASHER = METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> I FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> II = SINK(SERVICEIBAR/MOP/ETC.) = EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THI S APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIOINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED�41TH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORM1IANCE OF CONSTRUCTION. THAT I AIA AUTHORIZED BY THE <br /> OVJNER OF THIS PROPERTY TO PERFORM THE WDRK�FOR�ICHAPPLICATION I$MADE AND 1 COMPLY VdTH THE STATE <br /> CONTRACTORSlAW18.27RCWAND286200WAC. -� � <br /> . -- � �� /� �i "��-�� - <br /> i��ura ofOwnedContractodAuthonzed Agent Da�e <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> ��� <br />