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P�RMIT APPLICATIC .� <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADD�SS� � . P��L j�(�D����� PERMIT N � — <br /> 3 1�� 9v �� <br /> LEGA LOTNO. BLOCK TRACT S+'P Z� � � W <br /> DESC. S „ <br /> OWNER S V �+I�1VA'F+r.� 'I��Ev/V��� V{p���� �'Vn E I�Z�Z1Gb <br /> Jbt-�ci�1 I.+�IF-��I <br /> TENANTNAME CONTACTNAME PHONE <br /> �ltwwt� `"�o�►as 42.5-2 s'� -o�a <br /> CONTRACTOH ���� AODRESS � ! ��� �� ZIP CONTR.LICENSE N <br /> U /� <br /> PHONE l IW � �, J � V� f � VP'M� ��V1��j 1 V�S`C) <br /> PROPOSED USE OF BUILOING Building f�l Mechanical Addition HEA7 SOURCE <br /> PERMIT R Combinalion `� Plumbing WORK Alleralion (� Eleclric <br /> TYPE D Demolition ID`Sign TYPE New D Gas <br /> U Sprirkler RepaidMainL D Oiher <br /> CONTRACT PRICE OF WOHK � YW� ��� i f–rft-�- CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> r�! 1-tGts�'.. <br /> WORK OESCRIPTION <br /> ����Ln,e,�� Si� E� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C–A/HANDUNG UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) HEAT PUMP <br /> SHOWER _ UNIT HE�ITERS <br /> KITCHEPJ SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METHL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR ORAIN GAS RANGE <br /> I = BACKFLOW PREVENTER = GAS PIPING <br /> S�NK (SERVICElBAR/MOPlETC.) EXHAUST FAN <br /> OTHER OTHER <br /> � — — <br /> I <br /> I <br /> � I HEREBY CERITIFY'HAT I HAVE READ AND EXAMINED THIS APPI.ICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> iPROVISIONS OF LAWS AND ORIDINACES GOVEPNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERh71T DOES NOT PRESUh1E TO GIVE AUTHORIN TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br /> � STATE OR LOCAL LA6Y REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTPUCTION. THAT I AM11 AUTHORIZED BY THE <br /> ' OWNER OF THIS PROPERTY TO PERFORM THE WORK FOfi WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTOFS LAW 1827 RCW AND 296.200 WAC. <br /> ; 1��,�,� C� .�ri.�'�L s/9 o z <br /> Sig�r awre ol �vn iContracto Authorized Agent Date �\ <br />