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t'�� �oaa� �J t� �o a8 I _ <br /> � x <br /> 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.D.# PERMIT X <br /> 151 �m��a �v�. Oo55 i oo�OOc� Mc��-Ito-o,�.s <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP pHONE <br /> ��.�,�i�e� 1�19 �am�J0.h� � CIRc�ol �3-08�� <br /> TENANT NAME I CONTACT FOR PERMIT pHONE <br /> CONTRACTOR ���G�`�SS �I t�.[� ZIP CONTR.LICENSE# <br /> �� l <br /> ��r:�..l ln 3 <br /> PHONE <br /> °�°�gA�- qaa� <br /> PROPOSED USE OF BUILDING Building b� MeChanical Addition HEAT SOURCE <br /> PERMIT Combination �F� Plumbing WORK �RI--L Alteration Electric <br /> 1YPE DPmolilion L� Sign TYPE �-NeP �Gas <br /> S rinkler L� Re airiMainl Other <br /> CONTRACT PRICE OF WORK ��� V v CI'i'f OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> ����a..o �.�.�e�i �.,�:�.�-� � �ww��,o c.� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> BATHTUB = FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> I = FLOOR DRAIN _ GAS RANGE <br /> BF :KFLOW PREVENTER GAS PIPING <br /> _ SI�JK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> � - - � <br /> i � <br /> i <br /> i I HEREBY CERITIFY THAT I NAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAPAE TO BE TRUE AND CUHRECT. ALL <br /> I PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITN Wi1ETHER SPECIFIED HEREIN OR <br /> iNOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCe: 'f HE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THA"i 1.4M AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � C NTRACTORS LAW 18 7 RCW ND 296.200 WAC. <br /> ��Qi�r`IY�a 0 � Q(�:� � Gr1 �1��9 � ��'��'�"� <br /> Si�ture of OwnedContrectodAuthonzed A ent Dale I <br /> � DEBIT& CREDIT CARDS ARE NOT ACCEPTED � <br />