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po.i; <br />SITE ADDRESS <br />PARCEL TAX I.D. R <br />PERMIT M <br />LEGA LOT N0. <br />BLOC Iq <br />�,.11 <br />TRACT <br />DESC. 7 O <br />1& <br />i 1 <br />e.� _� ar <br />OWNER ADDRESS ZIP PHONE t��- <br />TENANT CONTACT R PERMIT/' <br />IINAME� Lam, n I �7 aO LI &Y'C, CCrl� <br />v-1 �\ <br />CONTRACTOR ADDRESS ZIP CONTFl. LICENSE M <br />PHONE `) r`,'( /� <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />Addition <br />HEAT SOURCE <br />l/_ <br />JZ) (��i�!q•"G' <br />PERMIT <br />TYPE <br />Combination Plumbing <br />Demolition D Sign <br />WORK Alteration <br />TYPE New <br />Electric <br />Gas <br />G�}('�(%tll r() 1/r <br />Sprinkler <br />LLL��J Repair/Maint. <br />U <br />Other <br />.en_�n.o.ne.e.�«n�..e�n.00eennu CONTRACT noe <br />PRICE OF WORK <br />7 I <br />r <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK aa <br />DESCRIPTION <br />Ii..i. Jo. C=n.ryr m'+�wre mun� ! <br />qc1�11 {�ev� -�o. /�#-,1� G �t-lltrrrc�ti� <br />III nnnsnenenuuxm�� <br />rwWxe <br />PLUMBING <br />ME <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />.e l . <br />NO. TYPE OF FIXTURE OR ITEM <br />� <br />WATER CLOSET— (Cr �F _ <br />AYE—AfHAt�}OCING�NIT_S <br />BA-T+fTiiB' <br />m�mm <br />F <br />_ <br />N) <br />HEhi'PD1UP <br />_ <br />4FI9WER" <br />1— <br />UNIT HEATERS <br />_ <br />K1ICH!<NSINK-& DISPOSAL <br />CLBT+IE3-DRYER <br />I _ <br />DISHWASHER <br />RAN6E+169D- <br />LAUNDRY -TRAY <br />I <br />WATER HEATER i�'•�•��� <br />_ <br />CL8THE9 WASHER <br />METo� c_�.,;R?�-. _-%m`_`�'9TOVE <br />•1313INAL <br />FIRERlA2E1RlSERT <br />DRINKING FOUNTAIN <br />G LACE <br />FLOOR -DRAIN <br />GA3'FiAIQGL- <br />BACKFLOW PREVENTER <br />GA3PtPING <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />OTHER <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE CF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORh1 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAG / <br />Signat re of Owner/Contractor/Authorized Agent Date IJ <br />DEBIT &CREDIT CARDS ARE NOT ACCEPTED L', 0 (2 <br />RMIT APPLICAl'IVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 —FAX 425-257-8857 <br />