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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-E810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI7 p <br /> ;.2 �� ` � 0 C 03 G D <br /> � � � t��,,,L, � , ���- '�� S ��0 3- 3c� <br /> LEGAL LOTNO. BLOCK TRACT <br /> oesc. /y /� / '2� Oi � D-on �� .�rl � �•s� / �✓ /.�, <br /> OWNER pDDRESS LP PHONE <br /> ��� I I <br /> ��rJ)c� ra_ ,)c�l� o�sc� r� .-22c�1 �'�,l«o�� � i1ue 7Y^G3 �7s- •�,76i' <br /> TENANT NAME I CONTACT FOR PERMIT PNONE <br /> f>q:-���.. ,a �t��i a.Y 7 �'SL:1S� 31"5-67L j. <br /> CONTRACTOR � ADDRESS ZIP CONTR.LICENSEN <br /> C�/Ct� :7 c r- <br /> PHONE <br /> PROPOSED USE OF BUILDING I Building f7 MeChanical I Addilion HEAT SOURCE <br /> � PERMIT R Combination F_� Plumbing WORK Alleralion I pElectric <br /> TYPE B DPmolilion �J Sign TYPE � Rew �j Gas <br /> �c%.»•�� ��[��r ��i .;c� � S rinklof paidMaint. U Olher <br /> CONTRACi P ICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> WORK DESCRIPTION <br /> __1, ., ,s :� l�: �", v ,� -r � � �r`� r� � �� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR REM <br /> _ WP.TERCLOSET AIC—AIHANDLINGUNITS <br /> _ BATHTUB FORCEDAIRS'(STEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> _ KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> I = LAUNDRY TRAY = WATER HE/�TER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> __ DRINKING FOUNTAIN GAS FIREPLACE <br /> _ FI.00R DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER GAS PIPING <br /> _ SINK(SERVICEBARIMOP/ETC.i EXHAUST FAN <br /> _ OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXMIINFD THIS APPLICATION AND KNOW THE gqME TO BE TRUE AND CORRFCT. ALL <br /> PROVISIONS OF LAWS AN�ORIDINACES GOVERNING THIS TlPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL IAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RQ AND 296200 WAC. <br /> /�:���T.t. �!`��.=� s/ lb� �o3 <br /> Signawre of OwnedContra rodAuthonzed Agent Date <br /> � <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />