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P�1MIT APPLICATIO�: <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857 <br /> SITE ADDRESS pARCEL TAX I.D.• PERMR• <br /> z � s � 6 �.� �� -o� <br /> LEGA L07N0. BLOCK TflACT <br /> DESC. <br /> OWNER ADDRESS LP PHONE <br /> �,�av�s.,tiJ Crn��q �� �� C.�..� � v� � z r) 3�K-o s(,� <br /> 7ENANTNAME CONTACTNAME pHONE <br /> � /�.,�. .,..,� c�, <br /> COnNT�R�AC70R AD�HESS i1P CONTR.LJCENSE M <br /> /'o'i 1`�-I�� �W� C 0✓�4'�', �J <br /> PHONE J S/ $.��.f��1�/`� NE P�I-C /FAI CQ q��NF <br /> � 2 �� 3 S9' Zd�b2 Mtnr,ylv;I(i, W✓�- ��-70 <br /> PROPOSEDUSEOFBUILOING Building R Mechenical (� Addition MEATSOURCE <br /> P ,�I TYPEIT Demol l o'n n U Sign bing rPE B R Pefr�/Mei�t. L' Om�ar� <br /> ,\ �� ` e�✓`��-- Sprinkler <br /> CONTRACT PRICE OF WORK CITY OF EVERETT IOCAL SALES TAX CODE IS�106 <br /> WOflK DESCRIPTION <br /> %�0,,- e��- o!d Ruo-�i� <br /> ��«�� rz'' PlyWo�� �_d �1.,.� co.N.��;�-,�aLL �e,o>� <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FlXTURE OR tTEM NO. TYPE OF FlICTURE OR ITEM <br /> _ WATER CLOSET _ A/C—A/HANDLIN('i UNITS <br /> i _ BATHTUB _ FORCED AIR SYSTEMS <br /> I _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> , _ SHOWER _ UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> _ DISHWASHER _ RANGE HOOD <br /> _ LAUNDRY TRAY _ WATER HEATER <br /> _ CIOTHES WASHER _ 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 HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br /> PROVISIONS OF LAWS AND OFIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING� f�F A P OES NOT PRESUME TO GIVE AUTHORITY TO VIOUITE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOC�A��y.qE TI ONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THqT I AM AUTHORIZED BY THE <br /> OWNER F IS`p�(OP T E ORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE S7ATE <br /> CON � / 296200 WAC. <br /> G-' � 8 z —QZ <br /> Signature of Owna��l:o ra utharized Agent ate ,/ <br /> � 1 <br />