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,� , <br /> •� • t .� - - <br /> • PERMIT APPLICA,TION ������ <br /> CITY OF `/ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT z <br /> soo ,,rvya �.� ss. �n�-. l� B�A. oa o64 oaoaa <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. � a'(j'(�L}� I <br /> OWNER ADDRESS ZIP PHONE <br /> t'A�RT�NS �6Sd 5bv� '�`OW00!) l.fll,1� POYq(�141.�+ O�. �f�a.2.0 $p3-b34—'a�$$ <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Aa�, vl�r1 Nm�N An��ac.A►���- 5v�l�flrLyul�2 �- 35�-3300 <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> �U!-�N�vt-� P�'�uCts, 7�'�. I8a71 �4u�UUJfi�C �Arcrc W. 98i8g �►.K.1�ll'td3 Sk <br /> PHONE <br /> PROPOSE�USE OF BUILUING BUilding f'1 MeChanical Adtlition HEAT SOURCE <br /> PERMIT Combination �_� Plumbing WORH RI�( Alteration Electric <br /> O��L,�`5��� 7YPE � DPmolition LJ Sign INPE �l NeP I � �as <br /> U S rinkler U Re air/Maint. Other <br /> CONTRACT PRICE OF WORK ���� �US\J�U. OtJI.�'l. CITY OF EVERETT LOCAL SALEt TAX CODE IS 9105 <br /> WORK CESCRIPTION . <br /> �u���a�a oF c.�a���.v� �,Pcx�U�- ir���;�� ��x ���r�� I <br /> PLUMBING MECHANICAL I <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 /> DISHWASIIER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WAShIER 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/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> —i — — <br /> I <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APFLIf,ATICN AND KNOW THE SAME TO BE TRU:AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COtdPLIED WITH WI-;ETH[R SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERPORMANCE OF CONSTRUCTION. iHAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM l'HE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY IMTH THE STATE <br /> CONTRACTORS LA6Y 18.27 RCW AND 296200 WAC. <br /> � ��� ��I a� <br /> Signa re f wner/Contract rlAuthonzetl Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />