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i <br /> - {. ._ <br /> P�tRMIT APPLIC,4T'IC�N <br /> CITY OF EVERET7 PERMfI' SI=RVICES <br /> 3200 CEDAR STREFT, EVERETT, WP.98201 <br /> 425-257-8810— FAX 425-257-48(i7 <br /> SITE ADDF2ESS 'P.RCEL TAX I.D.# PERMIT x <br /> / /S ��o {- c�crr c> � D '• �� _ J 3� D� <br /> LEGAL I_OTNO. BLOCK TRACT <br /> DESC. �, � G� ���� <br /> OWNER ADDRESS ZIP PHONE <br /> � � � <br /> �,'��,, C'i r, -�, � �' . ,��_���-t- 9 S.�o y �/z s 3/y 7�z <br /> TENANT NPME CONTACT FOR PERMIT PHONE <br /> ��.�, ��n,����c�i� ,� �i:, l�,-� ' �` 32� <br /> -�.Q— �/LS- _ /y-�� <br /> CONTRACTOR �1DDRESS ZIP CONTR.LICENSE# <br /> PHONE (��/,J2�� <br /> PROPOSED USE OF BUILDI4G l�Uilding 1SeChanlCal Additio�� HEAT SOURCE <br /> PERMIT � Combination R Flumbing WORK R Alleration D ElecUic <br /> �� 7YPE Demolition � Sig� TYPe R New Gas <br /> Sprinkler �-/ RepaidMaint B Other <br /> CONTRACT PRICE OF WORK CIIY O'r EVERETT LOCAL SALES TAX CODE IS 3�05 <br /> WORK DESC IPTION � / <br /> ����l^-O J-� �� ��-` L. <br /> ZQ � t�.� !/�'U� c�olL �w. �a w <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TY�E OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH B,ASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KiTCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHEf2 RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERI" <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BP.CKFLOW PREVENTEF, GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNO'N THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS.IND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED Wll H WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PCRM1IIT DOES NOi�PRESUM1tE TO GIVE AUTHORIN TO V!CIATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORAtANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY i O PERFORM THE VJORK FOR 1VHIGH APPLICATION IS MADE AND I COMPI.Y WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br /> �,��n � G/��/n� I <br /> SlgnaWre of 0 nedContra tor/Authonzed Agent ate —� <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />