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I � � <br /> PERIUIIT APPLICA7��N <br /> CITY OF EVERETT �?ERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, WA�8201 / � ��� <br /> 425-257-8810-FAX 425-7_57-6857 �� 3 G' � �` <br /> 1 -9 2.S- �Y�- ?e�,r? <br /> SITEADDRESS 'EYECC7'�` �.r/1-. pARCELTf.XI.D.# <br /> PER i <br /> ISO[: �hlPUsi�Y Sie�ej' c. ; 040z004OZc0 1 _ ��v <br /> LEGAL LOTNO. BLOCK TRACT <br /> OESC. � <br /> J �- f' � .�_ . <br /> OWNER __ <br /> ADURESS — <br /> IS�� (IJDUS�'K-��- .^_-,-�v:r-rZIP PH6NF. <br /> I �AtJATToN t b�=vEwPk�� �-y,�_��`r wA. `t& `L'�3 <br /> TENANT NAME CONTACT FOR PERMIi <br /> PHONE <br /> � i K- v h N 5�t Nl P�l��LE� �ZS--,rS�S 5� `f l o a <br /> CONTRACTOR <br /> lN1YEe.S4��- Ntnfifit.l�o1L ��,�(10E DDRESS <br /> 1 �g��p� �U�"0��� P�h p ZIP CONTR.LICENSE# <br /> PHONE q �&G� � `�t1tV�'�.� i3z.rf <br /> `'�'2.S ^ �"�^'J "' / IOC:. 1—'£�KOIJD W /1� r' <br /> PROPOSED USE OF BUILDING I 8vilding fyC Mechanical I <br /> PERM�T {� AGiition HEA!SOl1RCE <br /> Combinalion I-( Plumbing WORK �qlferation Electric <br /> 7YPE Demolilion I.] Sign 7ypE New <br /> � Sprinkler Cas <br /> Repair/MainL � Cther <br /> CONTRACT PRICE OF WORK � �' C T n 2� CITY OF EVERETT LOCAL SALES'MJ(CODE IS 3105 <br /> r LJ Jy <br /> WORK DESCRIPTION �v�S,�.��(� r- lO t,� CKS E, C'�1 r.lL r �'I'O Gv�O,J� (JN.i�. <br /> As„L�cit�dn,-1 �cfuct �,--'c,� t,�, ol��u�rs ��oT t�n/e�,.v�„gt-�t, I - gas Frr��( <br /> UTA�'I �/10Gt�"G( -�r, - -��f�F��PZP �1✓Ct�G'�(O✓l , VGiS PfrJIVlL1 , <br /> J <br /> I MECHANICAL <br /> � <br /> 'yi� D NO• NPE OF FIXTURE OR ITEM <br /> .. _----. ____ A/C-A/HANDLINGUNITS <br /> � � �� � � FJRCED AIR SYSTEMS <br /> G HEAT PUMP I <br /> L/ ������, 1 • J_ UNIT HEATERS <br /> V rJ � CLOTHESDRYER <br /> RANGE HOOD <br /> _ WATER HEATER <br /> METAL FIREPLqCE/STOVE <br /> � �'�O,u33 , / V i _ GAS F R PLACE RT <br /> �1� GAS RANGE <br /> _ � , � _� GAS PIPING <br /> --- � � � ��. ,p.l���.,�.� � � OTHERST FAN <br /> ; � -- <br /> ,� �� <br /> I I <br /> I HEREBY CERITIFY?HAT I HAVE READ AND EXAMINED THIS APPLICATION AN�KNOW THE SAME TO BE TRUE AN�CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERIv11T�OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CP.NCFL I HE PRO\�ISION OF ANY pTHER <br /> STATE OR l.00AL LAW REGULA7ING CONSTRUCTION OR THE PERFORMhNCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER Of?HIS PROPERTY TO pERFORM THE WORK FOR WHICH APPLICATION IS MADE A40 I COh7PLY WITH'f"HE STATE <br /> CONTRqCTQRb`LAW J 27 RGW7�?JD 296.200 WqC. <br /> ��/ sr� � '� ) � A <br /> /.�'I`�cG �e�. f.� :-n� � �-i',t./(:. '. ( ( ,e I z 1 <br /> SgnatUre ot nwneUConlractor/Authonzed Agen�'�C''i�? <br /> Date ,�1 <br /> U_ ____ _ _ DEBIT & CREDIT CARDS ARE NOT ACCEPTED � �' <br />