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�— ; <br /> ! P�R�i1' A,PPLICAI"ION <br /> i CITY OF• EVER!�TT PERMIT �ERVICES <br /> �� 320� CFUAR STREET, EVERETi', bNA 98201 <br /> i 425-257-3910— FAX 4?5-257-8557 <br /> I <br /> ISITtADDRESS I�� I PARCELTAXI.D # PERMIT# — <br /> ���5� . �!� s�eY�� �`8�os3o.s-� �az.. 31a ' �33 <br /> LEGA LOT[N� O. BLOCK TRVCT <br /> DESC. S/Ik�Q . <br /> OWNE� � ADDRESS ZIP PHONE ��� � ,� <br /> cl��Es l�'`;,;�,7piY C/� Col/%�.i-s (�/lG:a�� Sr � s3uw .Sea�t� Gc�z Y�'oj'' /-&�i�-/ S <br /> TENANT NAMF. � CONTAC'f FOR FERMIT PHONE <br /> � �G�'�IGL"�l f�DYi'� �l�l'1��? I �/fT���GfJHHe/���.r/� (�F���07�"�70� <br /> CONTRACTOR 7�(jQ ADDRES:r / n P CONTR.LICENSE# <br /> �V �v�v\ *Y�Q�('S vv� <br /> I PHONE � p �Y1,C�� p.v�(J� �'I �-3'��I��r <br /> I PROFOSED USE OF BUILOING Building fl Mech2nical Addi6on HEAT SOURCE <br /> �r I PERMIT Combination �_� Plumbing WORK Alteratlon Q Electric <br /> `'� ��� 7'YPE � DemoliliUn Ll Sign TYPE �New �j Gas <br /> Spri�kler L� 4epair/Maint. I� Other <br /> CON7RACT PRICE OF WORK ����pLYL O[J CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION ��/�/r ��f°�j/��Nti''�r <br /> M.���z �� �� r�� � ,6�„�n t��c��s��c�lri t�v -��1 5/°tiT Gu�-'/'�J" <br /> V}�,� �ui r� <br /> PLUMBING MECHANICAL <br /> NO. I Ti'PE OF FIXTURE OR ITEM N. NO. .� TYPE OF FIXTURE OR ITEM <br /> WATcR CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVNTORY(WASH 6ASIN) HEAT PUMP <br /> SHOJJER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHVJASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> , _ CLGTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACEINSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLO�R DRAIN GAS RANGE <br /> I BACKFLOW PREVENTER GAS PIPING <br /> � SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER _ <br /> iI HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED'N'ITH WHETHER SPECIFIED HEREIN OR <br /> � IJOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH€PERFORMANCE OF CONSTRUCTION. THAI'I AM AUTHORI2ED BY THE <br /> I OWNER OF THIS PROPERTY TO PERFORM THE WO FO�H CH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW'1827 RCW AND 296.Y00 WAC. <br /> Signature of OwnedContractor/Authorized Agent � te 'o�� <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />