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f'=l-iG-�C.-�c. C�:57 FEnI9:PEF49IT 4257755315 TQ:14e52572�`7 P. 1 <br /> � F �RMIT APPLICATI.�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADDRESS PqRCEL TAX I.D.# PER1dIT# <br /> 18"U � �-IoYT �-e_. C� o43 �v.� l9cb/oo��_�� �5 -Zv <br /> LEGAL LOTNO. BLOCI( TRACT <br /> DcSC. <br /> OWNER ADORESS ZIP PMONE <br /> 17a (�e ��c ((ar�l� lfi� l �1a1�`�'�e, �Pr.e� q�Lo r yztr 339 �"/�b <br /> TENANT NAME CONTAGT FOR PERtdIT PHONE <br /> ,C,/il d� yis 2�r� - 8 �i5�' <br /> CONiRAI�TOR � ADDRESS ZIP CONTR.LICENSE l7 <br /> w R,f+� iyw��� �'P,r1�7C[�J,�, /� <br /> PHONE G�'VUU /i�DI�Y) �E''e �j{ �C) C{Ir/liff//�.J��7�� <br /> 2.pG;n Z�L ��lX� ����_ 'LJ`' �,p'�4`f <br /> PROPOS[D USE OF[3UILDING Building ('�Mechanical Addiliun HEAT SOURCE <br /> PERld1T R COR1GIn3l'IOn L) Plum6ing IWORK �Alleralion n C-leCtriC <br /> r yii/ TYPE D Demolition D SI�Jn 7YPE ��1ew �R?Gas <br /> J r /L� U Sprinklor Rep�Ir/P.taint. LJ O�hr.r <br /> CONTRACT PRICE OF WORK / 2 93� � —' CITY OF EVERETT�OCAL SALES TAX CODE IS 710� <br /> / <br /> WORK DESCRIPTION � l <br /> lc f �-til--hKC� ��c� �f C�2 cJ <br /> {�P(CcGI/il � t U/�?!� ��,5 �'I <br /> �[� f-�.l�� � �L u �.f K��o <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTUR[ OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET(TOIL[T) A/C—A/HANDLING UNITS <br /> BAI�M�UB FORCED AIR SYSTEMS <br /> IAVATORY (WASH BASIN) HEAT PUMP <br /> � SHQVJER UNIT HEATERS <br /> KITCHEN SINK 8�ISPOSAL CLOTHES DRYER <br /> DISHtNASHER f2ANGE HOOD <br /> LAUNDRY TRAY WAl�ER IIEATER <br /> CLOTHES WASHER METAL FIFlEPLAC[lSTOVE <br /> URIN�L FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE � <br /> Bl�CKFLOW PREVENTER GAS PIPING <br /> I _ SINK(SERVICElBAR/M110P/ETC.) _ EXHAUST FAN <br /> � OTHER _ QTHER <br /> I — _ <br /> � <br /> � — — <br /> I I HEREBY CERITIFY THAT I HAVE P.EAU ANL'E?J+IAINED THIS APPLICATION AND KNOVJ THE SA�d@ TO O[TRUE A1�D CORRECT. ALL <br /> � PRO\9SIONS OF LAVGS AND ORIDINACES 60VERWING THIS TYPE OF WORK WILL BE COAIPLIED WITH N'HETHER SPECIFIED HEREIN OR <br /> NOT, THE GRAN7ING OF A PERMIT DOES NO7 PRESUME TO GNE AUTHORIN TO VIOLF'i c OR CANCEL THE FRUVI;ION OF ANv OTHER <br /> � STATE OR LOCAL LAW fiECULATING CONSTRUCTION OR TNE PERFORI.IANCE OF CONSTRUC,TION. THAT I A1.1 AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE VJORK FOR WHICH APPIICATION IS A1ADE AND I CO�dPLY WITH THE STATE <br /> li CONiR'CTORS lA .27 RCW AND 29620 <br /> ' � ���_ w, �� f�o o� <br /> , Si at re of OwneriGontractorlA i nzed Agent Date <br /> ; DEBIT & CREDIT CARDS ARE NOT ACCEPTED I <br /> --- ---- - ----- -J <br />