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� ERMIT APPLICAT�JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425 257-8857 <br /> SITE ADDRF_SS PARCEL TAX I.D.k PERMI7 x <br /> ��JO� c cra/�.x�cJ� .Kt��. Gd SO$'�,oaoo S�SD( 1 . U.� �� <br /> LEGA LOTNO, r BLOCK TRACT <br /> DESC. �v,- �� a��-Z.c�/ .S�'/�aF.�w��+�.Sc3� �..,i--�9��,L��E w..... <br /> OWNE�R/� ADDRESS 21P PHONE <br /> �c�.rFz.�,e.�� `���hsx 3a� �a�•o� �O/S �06� Fr/9����3 <br /> TENANTNAME I CONTACTNAME PHONE <br /> CONTRACTOR ADDRESS ZIP COt�TR.UCENSE M <br /> �«E �.�6E �.�w�;x�//,�.�. i�`3o� sd� t� ��c-��� 9a�b.rr <br /> PHONE/ \ � �o��� <br /> CZo�J �/�1'-�5</3 �c�v4« l.sf7 <br /> PpOPOSED USE OF BUILDING Building -RS Mechanical Addition HEAT SOURCE <br /> PERMIT Combination � Plumbing WOFX Ry Alteralion [] Electric <br /> S�2 riPE Demoiition LJ Sign 7YPE �q New �Q Gas <br /> Sprinkler U Repair.'Mainl. U Other <br /> CONTRACT PHICE OF WORM. ,� ��� �a CITY OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> WORK DESCRIPTION � / / ` ` <br /> /V CL�)� G�-� �2f��� �.v6t_.E' �'/�i..�r���i�,i,C�' <br /> � 2//d� <br /> iPLUMBING MECHANICAL <br /> I NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A!C—AlHANDLING UNITS <br /> —r BATHTUB / FOP.CED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> / KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> _L DISHWASHER / RANGE HOOD <br /> LAUNDRY TRAY / WATER HEATER <br /> � CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAtN / GAS FIREPLACE <br /> _ FI.00R ORAIN � GAS RANGE <br /> BACKFLO�V PFEVENTER � GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) 3 EXHAUST FAN <br /> OTHER OTHEA <br /> 1 HERE9Y CEF7ITIFY':IAT I HAVE READ AND EXAMINED THIS APPLI�ATION AND KNOW THE SAME TO BE TRUE AN7 CORRECT. ALL <br /> PRO':ISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED H[REIN OR <br /> NOT. THE GRANTI G OF A PER�AIT i:�ES NOT PRESUME TO GIVE AUTHORIIY TO VIOIATE OR CANCEI THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL REGUW7ING CONST UCTION OR THE PERFORMANCE OF CONSTRUCT�ON. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PR ?ERN TO PERFOF HE lYORK FOR WHICH APPLICATION IS M1tADE AND I COMPL'f WITH THE STATE <br /> CONTRACTORS 8.27,Ac.y�AND 29 . OQ WAC. <br /> � � (/ �L� ( <br /> � /d-2 b'-c��-- ^ <br /> Signa�ure ol Owner/ContractodAulhonzed Agent Date ,�a <br />