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PL,�MIT APPLICATICS.J <br /> CI�Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.A PERMIT x <br /> ��o � 'T�rro�e, oo�o� 00000 ��oo C�o�- o<� <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. 3 <br /> OWNER ADDRESS ZIP PHONE <br /> ���A�oo��meS�.�nc . �.D.�qbq.MA+c'u5V� ��Q. °Ig2��0 �3�dJ)�p53-�a'�'$ <br /> 7ENANT NA CONTACT NAME PHONE <br /> I ��e�e. �ahnson (�bo� 1�53-38�1� <br /> CO R CTO�R,`-`,�,�� pADDRpES�S 1�n LP CONTR.UCENSEN <br /> PNONE\ �MN.7V�. ������. 1.�� OOX �1D1'�Y'1�$�I II� QSa�a <br /> 3�0 �53-3a►�� ` ' 4t�p6EHro3amP <br /> PROPOSED USE OF BUIL.DING Building MecheniCal Addition HEAT SOURCE <br /> PERMIT Combinalion Plumbing WORK Alleratlon lectric <br /> r1 � Q TYPE Demolit(on Sign 7YPE New ��as <br /> � 1` Sprinkler RepaidMaint. U Other <br /> COM'RACT PRICE OP WORK CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> WORK DESCRIPTON <br /> ''c�.� �r�.er Cs.i'�cu�on <br /> I PLUMBING MECHANICAL <br /> INO. TYPE OF flXTURE OR REM NO. TYPE OF Fl1(TURE Oq ITEM. . <br /> WATER CLOSF.T A/C—AlHANDLING UNITS <br /> o'� BATHTUB T FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS I <br /> T KITCHEN SINK 8 DISPOSAL = CLOTHES DRYER <br /> �_ DISHWASHER � RANGE HOOD <br /> LAUNORY TRAY I WATER HEATER i <br /> T CLOTHES WASHER METAL FIREPIACE/STOVE <br /> _ URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN �— GAS FIREPIACE <br /> FLOOR DRAIN GAS RANGE <br /> I _ BACKFLOW PREVcNTER GAS PIPING <br /> � _ SINK (SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> I _ OTHER OTHER <br /> � — — I <br /> i I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TqUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH lA'HE7HER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PqESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> � STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOFMANCE OF CO�JSTRUC�ION. THAT I AM AUTHOFIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WfiICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RC D 29 200 WAC. <br /> `l.- --O a, ' <br /> Signalure ol wner/Conlractor Aul rized Agent ale � <br />