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� P�RMIT APPLICATIUN '� <br /> CITY O�F EoaR 8 REETPERMTT S ERVICES / ,�C���`�G 3� ' <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADDRESS � PARCEL TAX I.D.# PER(dIT� <br /> �� . � � I`�v �C�� � � - -�}"' I <br /> LEGAL L NO. BLOCK TRACT <br /> DESC. � — � -�.) <br /> OWNER ADDRESS ZIP PHONE <br /> _[1�1n�1'r1��C� ��,�1�+.e��tF� G��wc.�-�► �6Z1 I-��v'� �'f" <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � rti � G� ��� ���2-21.�� <br /> CONTRACTOR��� . , �U�� ADDRESS ZIP CONTR.LICENSEK <br /> !� �27 b�l l�l�: r �k��EpLP�(ii.�D� <br /> PHONE ./�-Z✓���!'�L�'�'✓ / Y `�GV��'� /��jV 1 .�/O/�G'�G� <br /> 11 <br /> PROPOSED USE OF BUILDING Buildi�g � Mechanical �,Q/�Addilion HEAT SOURCE <br /> PERMIT COmbination Plumbing WORK 9 ) Alleralion �[IecVic <br /> /+{ ��`� 7YPE Demolition Sign TYPE � New Gas <br /> �� Y Sprinkle� RepziriMaint Other <br /> CONTRACT PRICE OF WORK + ��Y���'j � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �!/.C,ti i <br /> WORK D[SCRIPTION <br /> � � �S �{�� <br /> Gvn�v�l-�� � �� �12�7 � � �-h� � -� x J 'I <br /> ����-�I� ���'A ��4 09 7 <br /> PLUM[TING MECHANICAL ! <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITE�d i <br /> WATER CLOSET(TOILET) _ A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) _ HEAT PUMP <br /> I SHOWER _ UNITHEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD , <br /> '� _ LAUNDRY TRAY _ WATER HEATER ; <br /> i _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL FIREPLr10E INSERT <br /> � DRINKING FOUNTAIN GAS FIREPLACE <br /> I FLOOR DRAIN GAS RANGE <br /> I BACKFLOW PREVENTER GAS PIPING I <br /> � SINK �SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN I <br /> I I OTHER OTHER <br /> i I — i <br /> i — — <br /> � I HEREBY CERITIFI'THAT I HAVE READ AND E.�(AMWED THIS APPLICATION AND KNGW THE SAME TO BE TRUE AND CORRECT. ALL '� <br /> PROVISIONS OF LAWS AND ORI�INACES GOVERNING THIS TYPE OF WORK WILL BE CCMPLIED WITH SVHETHER SPECIFIED HEREIN OR <br /> ' NOT. THE GRANTING OF A PERMIT OOES NOT PRESUA9E TO GIVE FUTHORITY TO VIOUITE OR CANCEL THE PROVISION OF ANY OTHER ; <br />� � STATE OR JtOG��LAW REGUWTING CONSTRUCTION OR THE PERFORAfANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE � <br /> OWNER O�T S P OPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COhiPLY WITH THE STATE <br /> cnNrRA,h �!a ia 97-urwf5#. 7C�]8 7nO WAC. <br /> _ � __�; �- -' �'�� �� <br /> � ignai ue oi OWftEnConlractor/Authorized Agent Date I� <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED �i <br />