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� � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE'f, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> �D3� �-03&� <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT� <br /> 0 / S . 0 - .p � .���' <br /> LEGAL LOTNO. LOCK T ACT <br /> DESC. �p C. <br /> �NER ADQR SS ZIP PHONE D�f <br /> � �'�E50 / /1� l• ' <br /> S11� �ad��,h. 97,��34�5 064�3 <br /> TENANT NAME CONTr CT F�R PERMIT PHONE <br /> �li''' Vah �tiGl 1Co�Q S�3 .�`f�4�� <br /> CONTRACTORPan���i ����� �� DORESS �, ���i„ya��^ ZIP CONTR,LICE� J / <br /> w P'�i�A G <br /> PHONE �D���` D '�� , �� <br /> �7 �� <br /> PROPOSED USE OF BUILDING BUilding i�lechanical Addition HEAT OURCE <br /> PERMIT Combinalion Plumbing WORK Alteration �Flectnc <br /> iYPE Demolition Sign 7YPE New Gas <br /> � Spnnkler I' RepairlMaint. Other <br /> � <br /> CONTRACT P CE OF WORK QQ CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> WORKDESCRIPTICN ^� / p f��� 5�a� � � `�4�� /J��I <br /> r1 c'j <br /> h��22����� s�/���vre. ' <br /> PLUMBING �CHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM TYPE OF FIXTU E OR ITEM <br /> WATER CLOSET A/C- NDLING UNITS <br /> BATHTUB FORC R SYSTEMS <br /> LAVATORY(WASH BASIN) HEA PUM <br /> SHOWER I HEATERS <br /> KITCHEN SINK 8 DISPOSAL THES DRYER <br /> DISHWASHER RAN HOOD <br /> IAUNDRY TRAY WATER TER <br /> CLOTHES WASHER METAL FIR CE/STOVE <br /> URINAI FIREPLACE IN T <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS R.4NGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICElBAft/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HERE�Y CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAMt TO BE�i RUE ANO CORRECT. ALL i <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WiTH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAYTING OF A PERMiT DOES NOT PRESUME TO GIVE AUTHOftITY TO VIULATE OR CANCEL THE PROVIS!ON OF ANY OTHER <br /> STATE OR LUCAL LAINREGUTATING CONSTRUCTION OR THE PERFORMANCE OF CON57RUCTION. THAT 1 AM AUTHORIZED BY THE ' <br /> OWNER OF ROP TY TO PERFORM THE WORK FOR WHICH APPUCATION IS MADE AN�I CUMPLY VJITH THE STATE <br /> CONT LA 82 RCW AN 96.20 . <br /> ' at n U uthonzetl gent Date �a�nf ���/ <br /> �N1.� �4���i lcT� '�� <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED J <br />