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rERMIT APPLICAT�t�IV <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 a <br /> 3o L �� (1'i c�3r�2-o � ' <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS Lp pHONE <br /> Jo� arOV� �61(. l_ari�e�-D�+�ir, �' �S� '-F�� 338" 2G� <br /> TENANT NAME I CONTACT NAME PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE B <br /> PHONE �U f , n � l <br /> ��x�� <br /> PROPOSEO USE OF BUILDING f� Building D Mechanical Addition HEAT SOURCE <br /> PERMIT �-� Combination U PlUmbing WORK R Alteration n Electric <br /> 7YPE � � Demolition <br /> u U Sign TYPE New g Ges <br /> S�� u SUrinkler(k of heads) Repair/Maint. Olher <br /> CONTFlACT PRICE OF WORK 'CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORk DESCRIPTION <br /> �'�,�� � ,��lA� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIa7URE OR ITEM NO. TYPE OF FIXTURE OR REM <br /> _ WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> _ BATHTUB _ FORCED AIR SYSTELIS <br /> _ IAVPTORY(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 T GAS FIREPLACE <br /> _ FLOOR DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER � GAS PIPING <br /> _ SINK(SERVICE/BAFUMOP/ETC.) _ EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I HEREBY CERITIFV THAT I HAVE READ AND EXAMI�'ED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AfJD CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK\VILL BE COMPLIED WITH WHETHER SPECIFIE�HEREIN OR <br /> NOT. THE GAANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PEP.FORMANCF:OF CONSTRUCTION. THAT I AM AUTHORIZED BY THL- <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATI�7N IS MADE AND I COMPLY WITH THE STATE <br /> CO TFACTORS LAW 18.27 RCW l.ND 296.200 WAC. <br /> �- � 1 �" <br /> Si ture of wnedContractoUAuthonzed Agent ate � <br />