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� rERMIT APPLICATiJN <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.# P RMIT u <br /> 33�� L�-,...,_1�,�,- o.l ooy39o �9S-o-olol 1��30�1-001 <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER A�DRESS ZIP PHONE <br /> C'�r.vI�ASS � Lr� � �. <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> � 2�e �! � L �� � � Lj25-Sots-3o4Ff <br /> CONTRACTOH �G� S ,�,n n £ �w,� ADDRESS � ZIP CONTR.LICENSE# <br /> L`�- �J�_ ��c <br /> PHONE 2 �� ��c �' �3 � �o ZZ�Q j/✓<JG.o�vt/S ti 9�'z 5 / Co25�F l �i5'F�g <br /> ) <br /> PROPOSE�USE OF BUILDING Building D Mechanical Addition HEAT SOURCE <br /> PERMIT � Combination U Plumhing WORK � Alteration � Electric <br /> TYPE Demolitian U Sign TYPE PJew Gas <br /> Sprinkl0� Repair/Maint. Other <br /> CONTRACI'PRICE OF;;'ORK � 6 G O � ^ CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIP'.ION <br /> 1/G�v. o .�' �£rn o v.�-� O h v `• ,'� `� � h � . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C—AlHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASNER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOU�iTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOVJ PREVENTER GAS PIPING <br /> SINK(SERVICE/t3AWMOP/ETC.) [XHP.UST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KN01Y THE SAME TO OE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL Be COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> iNOT. THE GRANTING OF A PERMIT DOES NOT PAESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL L1W REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I A�d AUTHORIZED BY THE <br /> OWNER OF THIS PROPERN TO PERFORht THE WORK FOR WHICH APPLICATiON IS MADE AND I COMP!Y WITH THE STATE <br /> CONTRACTOR�827�W AN q,z . C. <br /> ?� /7i �/G^p � <br /> � <br /> i Signe'�ure of OwneuContractoUAulhorized Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />