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� S ,� <br /> PERMIT APPLICATIC�N <br /> CITY OF EVERETT PERMIT SERVICES � `�6`� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ���0� �� <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT u <br /> � x rz�� �v� � oS 3 <br /> LEGA LOT N . BLOCK ��, TRACT <br /> DESC. S' �� - es� j�D S y�t � D I IODOC� �'j <br /> OWNER ADORESS ZIP PHONE <br /> ��ti�a� (,��� 7� � �k las�. V� �Y��l��m ww� � ��,� <br /> NANT NAME CONTACT FOR PERMIT PHONE <br /> ��N�l� �N' L��� � �, � r� Uz5 '�S9- . O�(D <br /> CONTRACTOR ADDRESS � �� �"` � ZIP CONTR.LICENSE N <br /> � n, <br /> PHONE /` /� ,� o n ,/ C'� <br /> �/ /v�-v <br /> PROPOSED USE OF BUILDING � Building fl Mechanical Additlon HEAT SOURCE <br /> lj,,,...JJJ u(y�,� �GpIti�LY PERMIT Combination i::� Plumbing WORK�Aiteratlon �ElecUic <br /> � e S 1. 1 e����JV ( TYPE �emolition Ll Sign TYPE New Gas <br /> �Y Sprinkler RepaiRMaint. Other <br /> CONTRACT PRICE OF WORK L�/`�) CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> J ��CA/ <br /> WORK DESCRIPTION <br /> `�-P � ��- <br /> PLUM8ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> �- WATER CL,OSET(TOILET) � � � A/C—AlHANDLING UNITS <br /> ,:! ' ' BA i HTUB��7!- Z FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN)fJ�% � � HEAT PUMP <br /> ' I�iL� SI�OWER/ UNITHEATERS <br /> T KITCHEN SINK 8 DISPOSAL = CLOTHES DRYER <br /> / 1 ' DISHWASHER / RANGE HOOD <br /> " LAUNDRY TRAY I1 T WATER HEATER <br /> ! CLOTHES WASHER METAL FIREPLACE/STOVE <br /> � URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN ,� GAS FIREPIACE /// <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN j�{L //// <br /> OTHER OTHER <br /> I <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> I pROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH WHETNER SPEGFIED 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 /> ISTAT C L LAW REGU TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br /> OW R OFjHIS PROPE TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONT ApTORS LAW 18 RCW NO 296.200 WAC. <br /> � <br /> Si f ne ractor/Authon ed Agent Date <br /> EBIT REDIT CARDS ARE NOT ACCEPTED I�Z <br />