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�. ERMIT APPLICAT�_ JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> :;��s �G2// -025 <br /> SITE ADDRESS PARCEL TAX I.D.N P MIT A <br /> . r �593b 636 ��07 O� <br /> r -��U 1 Ct U <br /> LEu�a LOT NO.� BIOCK TRACT A,n n <br /> DESC. '7 � f � 3� SWALwcc(,S Z ��r�(�ZT�d/v <br /> O�YNER / ADDRESS ZIP PHONE �'z� _ <br /> '-�nt�`r ��os. C�NS-z- c�u�;�o,� 3`,22 ���A�c; uE. E�.cac�� 5�z�� .3ri�-73Go <br /> TENANTNAh1E CONTACTNAME PHONE <br /> 1��e1 Nau�k �{2S_2��c�- 2 ��29 <br /> CONTRACTOH ADDRESS ZIP CONTR.LICENSE M <br /> N���ck �ec�s. 3922 a��A�;:. tiC ���ac-� �s2�S <br /> PHONE_ <br /> �125- 3`�1 -'7 3�o �-I�(�ck s3 z� 12 DZ <br /> PFiOPOSED USE OF BUILOING Buiiding f, Mechanical Addition MEAT SOUqCE <br /> �� PERMIT � Cambinati0n �� PI9m6ing WORK � Alteralion � Electric <br /> �� 1 � �( TYPE Demolilion �J Si n TYPE Ne�v Gas <br /> Sprinkler RepairlMmnL Other <br /> CONTRACT PRICE OF WOHK �1 � ��� �� CITV OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> O\ <br /> WORK OESCRIPTION <br /> Ncw y- ��1ex <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSE? A/C—A/HANDLING UNITS <br /> BATHTUB � FORCED AIR SYSTEMS <br /> I� . LAYATORY (WASH BASIN) HEAT PUMP <br /> _ 'SHOYJER UNIT HEATERS <br /> � KitCNEN SINK 8 DISPOSAL CLOTh{ES DRYER <br /> � DISHLV�SHER � ANGE HOOD <br /> LAUNCRYTRAY � TER HEATER <br /> 3 CLOTHESYVASHER ME LFIREPLACE/STOVE <br /> UP.INAL _ FIREP CE INSERT <br /> DFINKING FOUNTAIN _ GAS FIR LACE <br /> FLOOR DRAiN GAS RANG <br /> BACK'rLOW PREVENTEA GAS PIPING <br /> SINK (SERVICE�BAR/MOP/ETCJ _� EXHAUST FAN <br /> CTHER _ OTHER <br /> .E�EB'I CERI7IF'/'HAT I HAVE R&10 AND EXAIdINED THIS APPUCATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> aROVISIONS CF LTWS FNO ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPUED WITH WHEfHER SPEGFIED HEREIN OR <br /> '!OT THE GRPNTING OF A PEFIAIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHER <br /> S i ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> CWNER CF i HIS PROPERTY TO PERPOR�A THE'f/ORK FOH WHICH APPLICATION IS�dADE AND 1 COh7PLY WITH THE STATE <br /> � 4TRAC S I.AW 10. RC'N AND 2 00 VJAC. <br /> \ I - _p2 <br /> �gnalu of wneuConlra or uthonzed A ent Date <br /> '� , (3�a�1� �, � 5 �Iz <br /> `� <br />