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- ( —� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 90201 <br /> 425-257-8810- FAX 425-257-8857 <br /> �OOG t�.���� <br /> SITEADDRESS PARCELTAx1.D.11 ����_ Z� <br /> _ � Ci �I'i:��J�- !.1/1 }�j�l�c _ <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> � /�/ � � � � i � t.i�_��o�� `y,j) 257-:4Xo <br /> ��(�G!'li�J�- /`i/�C ��Y+/'/iG� yy f� �/Y'�i�lW'�Y �i r.�' / (I <br /> i <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Ct tfe�r�J���� I G3�«„� /I�,�;��J1— lut'J 3%F -s�/7 I <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSER <br /> f�c%�ir,qi7j�'�7 �:�»>�J..�9_ !!/� i7.'.� 7a•/ i�r� F! <br /> � /� 9�r'iL %J�,CP9/iCLrIQ':i�;T <br /> PHONE �:a-.7�� /� i ' <br /> PROPOSED USE OF BUILUING n Building � MeChaniCal ntldi:icx� I HEAT SOURCE <br /> I PERMIT n Combinalion Plumbing WORK At�eration RE-bciric <br /> C`.��`>f�f�`.fY, I� TYPE H Demolilim Sign TYPE � New G Gas <br /> � � L! Spnnkler U RepaidMaiN. Other <br /> CONTRACT PRICE OF WORry/,/����j �r% CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> N � <br /> WORKDESCRIPTION �>�7�/ .rl l/�7 // !'�'1- �.v�_s. cv.�7f,.��i.�L.nz. i� Sii7 /-/ fti"'.. <br /> ��!"� i [�� ( _ ��. ..�i75. � <br /> �_ .'� S��I �li r. ili� �7-a.�•' ��/'•` � <br /> •�..•'. I <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIl(TURE OR REM NO. TWE OF FIXTURE OR REM <br /> WATER CLOSET AIC-NHANDLING UNITS <br /> 8/1THTU8 FORCED AIR SYSTEMS <br /> LAVnTOR\'(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATFR HEnTER <br /> CLOTH[S WASHER METAL FIREPLACEISTOVE <br /> URINAL FIREPU�CE INSERT <br /> DRINKING FOUNTAIN GAS FIREPL�CE <br /> � FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER GAS P�PING <br /> �� SINK(SERVICEIBARIMOP!ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERIIIFY THA7 I HAVE REN]ANU EKAMWED THIS APPLIUTION AND KNOW THE S�ME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDWACES GOVERNING THIS TYPE OF WORK WILL BE COh1PLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAN7ING OF A PERMIi DCES NOT PRESUME i0 GIVE AU7HORIlY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> ST�1E OR LOCAL LAW REGUL�TING COI �TRUCTION OR iHE PERFORAIANCE OF CONSTHUCTION. THAT I AM AUTHOfiIZE�BY THE <br /> OWNER OF THIS PROPERiY TO PERFORM THE WORK FOR WH�i.H APPLICATION IS MADE AND I LOMPLY W�TH THE STATE <br /> CON�TRACTORS LAW 18.27 RCW AND 296.200 WAC. � <br /> �„� � �/��/�� <br /> Signalure ol OwnerlGonVaclorl�uthonzed Agem Dale <br /> I _ _ DEBIT$ CREDIT CARDS ARE NOT ACCEPTED <br />