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�— � <br />PERMIT APPLICATIO�N <br />CITY OF EVE►�ETT PERMIT SERVICES <br />3200 CEDP.H STREET, EVERE�, WA 98201 <br />425-257-8810 - FAX 425-257-8A57 <br />SITE AODRESS I PARCEL TAX I.D. N <br />LOT NG. I BLOCK I TRACT <br />TENANTNAMt <br />CO�TACTNAME <br />PERMIT K <br />PHONE <br />� �c�., ,tc;.4ir..s�,,..-��z.�,s���� �bu�S�e3-��6Z <br />CONTRACTOR � ' ADDRESS LP CONTR. UCENSE N <br />.��/_NNSi�i.l �%Ci»13. 1�l1i3[l /'/-�/ni•y�L' /�-�C� <br />PHONE �/!�„�Gn.,,. `I�YI.Lj IeG�f3/NPaI�'L7LLL� <br />l3G�c�J S�� � �v(.�z <br />PROPOSED USE OF BUILDING <br />S �. � <br />Building Mechanical <br />PERMIT R Combination R Plumbing <br />TVPE fi Domolilion � Sign <br />4� Sprinkler <br />CONTRACT PRILE OF WORK �, � <br />WORK UESCRIPTION <br />/�v5i�zi `7k"'t <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SIN�C & DISPOS' L <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK ISERVICE/BAR/MOP/ETC.) <br />_ OTHER <br />S i'.�'i �iic_r.:� S' <br />NO. <br />Addition HEAT SOURCE <br />Alleralion (7 Electric <br />New ❑ Gas <br />Repair/M1ininl. D ome� <br />CITY OF E\'ER6"7T LOGAL SALES TA% COOE IS 31L5 <br />/ �v NC'� v .f F.� <br />MECHANICAL <br />I TYPE OF FlXTURE OR REM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPI.ACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXH�USTFAN <br />OTHER_ <br />S <', �v:Cc c'i� Na-JS <br />I HEREBY CERITIFY THA71 HAVE READ AND E)(AMINED THIS APPLICATION AND KNOW THE SAA1E TO BE TRUE AND �ORRECT. ALL <br />PROViSIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE 0+= WORK WILL BE COMPLIED WITH WHETHER SPE�IFIED HEREIN OR <br />NOT. THE GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO�ISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORht THE WORK FOR WHICH APPLICATION IS h1ADE AND I COMPLY WITH THE STATE <br />CONTRACTORS (..1W J837 RCW.AND 296200 WAC. <br />'IL <br />