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PE'��MIT APPLICATIO� . ���� <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERE i T, WA 98201 <br /> �i25-257-8810— FAX 425-257-8857 <br /> 2Sll �'a r.���,� �� <br /> SITE ADDRESS pARCEL TAX I.D.N PERMIT M <br /> ODS G/Z(7'L 6r G�D COe4-O�p <br /> IEGA LOT NO. BLOCK TRACT <br /> DESC. Z 6 <br /> OWNER ADDRESS ZIP PNONE <br /> "T�EKAn�T OFdEcv�MF.✓r Po d�x�2�Mtik,'l�ro q�z�r yu""y �g�, <br /> TENANTNAME CONTACTNAME PHONE <br /> �CE!_G / GAEnI �- yZ�t��a'(corff <br /> CONTRACTOR TQ,EK�.�r A�ORESS ZIP COMA.UCENSEN <br /> ,DEdFcuP�+E,�r �° Q�y G z g <br /> PMONE '`J�Z } �REK�� � 9Z <br /> 2r Ma �� l��o wrq S <br /> PROPOSED USE OF BUILDIN6 Building Mechenical Addition HEAT SOURCE <br /> 2 4B4 SF PEHMIT Combination R�...( Plumbing WORK R�,,[ Alteretbn R Elecric <br /> t �� TYPE Demolit(on u Sign IYPE R New �] Ges <br /> iE�� �' Sprinkler U qapair/Meint U Other <br /> CONTRACT PRICE OF!NORK � /t's' OOO j �� CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> WORK DESCRIPTION <br /> .Nc� n ; o� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl7fTURE OR REM NO. TYPE OF Fl1(TURE OR REM <br /> WATEF CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB o�- � FORCED AIR SYSTEMS <br /> LAVATORY WASH BASIN) HEAT PUMP <br /> � SHOWER � _ UNITHEATERS <br /> KITCHEN SINK 8 DISPOSAI CLOTHES DRYER <br /> OISHWASHER g RANGE H000 <br /> � LAUMDRY TRAY _� WATER HEATER <br /> _� CLOTHES WASHER METAL FIREPLACEJSTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIFEPLACE <br /> FLOOR DRAIN GAS RANGE <br /> � BACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICE/BAWMOP/ETC.) EXHAUST FAN <br /> OTHEF OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> PFOVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR �i <br /> NOT. THE GRANTING Of A PERMIT DOES NOT PRESUh1E TO GIVE AU7HORITY TO VIOLATE OR CANCEI THE PRO'71SION OF ANY OTHER <br /> STATE OR IOCAI LAW REGULATING CONSTRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE ��, <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS M4DE AND I COMPLY WITH THE STATE <br /> CONTRAC FlS LAW 18.27 CW AND 298. C. <br /> �/, � —� -Q L �{� <br /> Signalure Owner/ContractodAuthorized Ag ate y� � <br />