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PERMIT APPLICATION <br /> CITY 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.I7. # PERMIT u <br /> ��/� /��i4ca�r�� �yinc�c�c�-��g��c�a /� c�o� � oi <br /> LcGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER AD�RESS ZIP PHONE <br /> �Nl4�e��"S SPa��S� sc�lu f�ZRc=c��� �cr 9,�zvl <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> . �U`� �,'z,�zsY-�zSo <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> ��Pr��F��( cor.c si_ r x c 3px �zo�c� ���Z�7T u�k 4�'zo� <br /> PHONE 1� ZS - Z��'/'72.SV <br /> PROPOSED USE OF BUILDING Building f"l Mechanical Addition HEAT SOI.'CE <br /> PERMIT B Combination �_� Plumbing WORK R AlteraGon (� Elea.��- <br /> iYPE D Demolition Ll Sign TYPE D New D Gas <br /> U Sprinkler U Repair.�MainL U Other <br /> CONTRACT PRICE OF WORK � � ��-� _ CI1Y OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> WORK�ESCRIPTION �Ox5j��2�LT�Q'F C)F' I{ ��"+"�?C�JO � l7CzTE�Gtcnv c.Jr�-' iOT- '� <br /> i <br /> PLUMBING MECHANICAL I <br /> I N0. TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C-AIHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BhSIN) _ HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAI. CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> I _ LAUNDRY TRAY = WATER HEATER i <br /> CLOTHES WASHER METAL FIREPLACElSTOVE I <br /> URINAL <br /> FIREPLACEINSERT <br /> � DRINKING FOUNTAIN _ GAS FIREPLACE � <br /> FLOOR DRAIN GAS RANGE i <br /> BACKFLOW PREVENTER GAS PIPING I <br /> SINK(SERVICE/BAR/titOP/ETC.) _ EXHAUST FAN � <br /> _ OTHER _ OTHER i <br /> — � <br /> � _ —I � <br /> I I HEREBY CERITIFY THAT I HAVE READ AND E,KAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> � PROVISIONS OF V+WS AND ORIDINACES GOVERNING THIS TYPE OF WORK\NILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR � <br /> i NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER I <br /> '� STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THA71 AM AUTMORIZED BY THE i <br /> ' OWNER OF THIS PROPERTY TO PERFORM THE�VORK'rOR N'HICH APPLICATION IS MADE AND I COMFIY WITH THE STATE �� <br /> CON CTO LAW 18.27 RCW AND 29"a.200 4VAC. I <br /> I ��� -� � 2 -�,' ��' <br /> ,�.� . I <br /> i '�ignat (oeru OwnedContractor/Authonzed Agen[ �ate / <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED / Z <br />