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SITE ADDRESS <br />�a I 5 <br />LEOA LOT NO. <br />DESC. � A _ <br />�L 5.% �e <br />TENANTNAME <br />/� <br />PERMIT APPLICATION <br />GITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />BLOCK � TRAC7 <br />T�'r,-, b 0 � <br />// <br />PARCEI TAX I.D. • <br />- J2 <br />,22/ S �NC� u rS%F <br />�`T'���j ME�lcS�CIZ <br />CONTRACTOR ��� r,�, � oL�, fi Os� Ci �/ S�DDRESS � yI S <br />PHONE /_/1 S <br />�7 1 <br />aszsysa <br />PROPOSED USE OF BUILDING <br />�� <br />Cec(, <br />Building Mechanfcal <br />PERMIT Combinelion Plumbing WORK <br />TYPE Demolitlon Sign TYPE <br />Sprinkler <br />CONTRACT PRICE OF WORK �//Ql/O <br />WORKDESCRIPTION �GKndk���� %�-2 A�✓" <br />� <br />NO. I TYPE OF FlXTURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAI <br />DISHWASHER <br />IAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />PE MIT 11 <br />o�ro-osc� <br />� <br />,�S 3%9 �9� 9 <br />i1P CONTR. UCENSF.1 <br />yg�ol Fou•�dcCo 5.? <br />�AddHbn <br />Alle�albn <br />New <br />HapaidMeint. <br />HEATSOUNCE <br />j7 Eleclrb <br />Oea <br />OIMr <br />CITY OF EVERETT LOCAL SALEB TF% CODE 18 �105 <br />MECHANICAL ' <br />NO. I TYPE OF FlXTURE OA ITE�I <br />� <br />� <br />A/C — A/HANDLING UNITS . <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />OAS RANQE <br />OAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEFEBY CERITIFY THAT I HAVE REAU AND E%AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERE�N OR <br />NOT. THE GHANTING OP A PERMIT DOES NOT PRESUME TO QIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHEH <br />STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTO W 18. CW AND 296200 WAC. <br />rv����Ul <br />Si ture o OJvner/ onlra r/Aulhorited Agent ale �l2 <br />C <br />