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� �_�` <br /> E��:;RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SEfi�lICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810- FA;<425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.H PERMIT# <br /> ���a- 1��7� � � 011� 'Ol/ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ' ADDRESS PHONE <br /> �,rJr����v� .������� �„�a,�a av, ���_�- s6� <br /> TENANTNAME I CONTACTNAME PHONE <br /> �� <br /> CON7RACTOR � ADURESS CONTR.LICENSE# <br /> S � P C�-�� <br /> PHONE /Z9Z� ��GC-E(��' <br /> p- , � 33 5�coaU /y/ /���' <br /> PROPOSED USE OF BUILDING Building � Mechanical Addition HEAT SOURCE <br /> PERMIT �Combination Plumbing WnRK �Alieraiion (� eiectric <br /> TYPE Demolilion Sign TYPE New Q Ges <br /> !7�. Sprinkler RepaidMaint U Olher <br /> K <br /> CONTRACT PRICE OF WORK O@p�p CITY OF EVERETT LOCAL SALES TAX COGE IS 3105 <br /> WORK DESCRIPTION ���L,,�C� (�{)/iYJOOW S -- FKAUT � /1�'e �OD2S � �EPLd1G � <br /> G�1L ;�iDE" — /U�4> Cvv�v �2 To�S— /UELcJ Br4r,�lJ��v��� g -5� . <br /> .5 v�/�.+D • <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET 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 /> v D�SHWASHER RANGE HOOD <br /> 'J IAUNDHY TRAY WATER HEATER <br /> CLOTHES WAS�IER _ 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/ETCJ k EXHAUST FAN <br /> O E OTHER <br /> — � ���`�G — <br /> Fs/� - <br /> I HEREBY CERITIFY THAT I HAVc READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BF.TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH l'�HEfHER SPECIFIED HEREIN OA <br /> NOT. THc GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OH LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TFIAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATe <br /> CONTRACTORS LA—W7 1827 RCW AND 296200 WAC. <br /> �`y `�yG¢/�2C� �D /v o <br /> Signature of w er/ContractodAuthorized Agent Da e <br />