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pC�MIT APPLICATIC�V � <br /> CIT'Y OF EVERETT PERMIT SERVICES } „ �, <br /> 3200 CEDAR STR.=ET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> �b� �-� —.. ; <br /> PARCEL TAX I.D.N PERMIT N , / <br /> SITE ADDRESS r v� � C(7 �� <br /> � �� J1 ��rc t ;,�? �5sa�l vo 0 <br /> LEGA LOT NO BLOCK 'AnT 90 D 3��a s P <br /> DESC. 4 f'� <br /> OWNER ADORESS LP PHONE <br /> � Eiv.��.Q. ses �.C, . 3a- 3s A.�.ZS� �4Q�� �a.s - �y3� �l �Q <br /> TENANTNAME <br /> CONTACT NAME PHONE <br /> I (�y�: l..ess��, y�, -�y�- ��� e <br /> ��- Lp CONTR.LICENSE Y <br /> CONTRACTOR . ADORCSS <br /> Ac4a,�a_`�c��eQ-Qct��e�i�l.•t �-�b�a-.3s�Ao'��G 4,&�� A�1�R�w3a�� <br /> PHONE <br /> uildin fA-Mechanical Addition HEAT SOURCE <br /> PROPOSED USE OF BUILDING � 9 ���p 9 Elech!c <br /> PERMIT Combinelion F_� lumbin WORK Alteration �Gas <br /> 5� n \.z. Faw�� 7YpE Demolition �� Sign nPE e`° <br /> `� � Sprinkler Repeir/Meint. Other <br /> �+!�c C�+1N��' <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> WORK DESCRIP710N • , <br /> s�,n5�� F�..�y t��.�-w►� ��. ���,,« �� c� � <br /> PLUMBINC MECHANICAL <br /> N0. TYPE OF Fl%TURE OR ITEM NO. TYPE OF FlXTURE OR ITEM - <br /> � WATER CLOSET A/C-A/HANDLING UNITS <br /> �_ BATHTUB _L FORCED AIR SYSTEMS <br /> �_ LAVATORI'(WASH BASIN) _ HEAT PUMP <br /> �_ SHOWER UNIT HEATERS <br /> _L KITCHEN SINK 8 DISPOSAL �_ CLOTHES DRYER <br /> _� DISHWASHER �_ RANGE HOOD <br /> � LAUNDRY TRAY �_ WATER HEATER <br /> � CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN �_ GAS FIREPLACE <br /> FLOOR DRAIN � GAS RANGE <br /> BACKFLOW PAEVENI'ER �_ GAS PIPING <br /> SINK (SERVICEIBAFUMOP/ETC.) _ EXHAUST FAN <br /> OTFIER_ _. OTHER <br /> — I ' <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED TH�S APPLICATION AND KNOW THE SAME TO BE TRUE AN�COPRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WOqK WILI BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE�3RANTING OF A PERMIT�OES NOT PRESUME TO GIVE AUTHORITY TO VIOUITE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL tAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOP WH�CH APPLICATION IS MAOE AND I COMPIY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 29&.200 WAC. <br /> \ <br /> ��� �����.SS-�'f �` �" ?- <br /> Signature I OwnedContract r/A thonzed Agent e1� <br /> �Z <br />