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9 <br /> P�RMIT APPLICATIOaN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810- FAX 425-257-8i357 <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT# <br /> zi ► � �,o„� b�a A�� �ou�a � u��� �000 � bS � o <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. �D 'f \ u3� �7mm <br /> OWNER ADDRESS ZIP PHONE <br /> C,•'�� h �e��ti� Smi��� 2 ( l`� �o�b�c� �ve `��< <tzs �s& 6y5� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � S�,V�e. <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> k- l-oo�r �0��54. �� I� ��ti, f0io'I Kenwanda �r 9Sz9/ <br /> PHONE c5V10�'10N'1�6 � �a kFouRCRol�b�� <br /> �3� �S - zcoo <br /> PROPOSED USE OF BUILDING Building FX1 Mechanical Addition HEAT SOURCE <br /> PERMIT g Combination �_� Plumbing WORK � AI!eralion � Elecf.ic <br /> �� TYPE D Demolition LJ Sign 7YPE New Gas <br /> � � u Sprinklet RepaidMaint. Other <br /> CONTRACT PRICE OF WORK q( SCCO CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> J� <br /> WORK DESCRIPTION <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 8 DISPQSA� 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 /> FLOOR DRAIN GAS RANGE <br /> 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 GOVEP.NING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ; NOT. 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 THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF T I�ROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION i.;MADE AND I COMPLY WITH THE STATE <br /> CONTRACj S �/18.27 RCW AND 296.200 WAC. <br /> J � `� Z� �� <br /> Signature wner/ ontractodAuthorized Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />