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i '— <br /> � � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET(, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS . � PARCEL TAX I.D.# PERMiT a <br /> , 71-7 C /, ,,����c- /�?��� oo f'� z`�a/ oo�3vo , -o <br /> LEGAL LOTNO. BLOCK TRACT T � • <br /> DESC. � � ! G �I/�=/?�) N/��_$ !��//!S/Or�/ /�IG• Z- <br /> OWNER ADDRESS ZIP PHONE <br /> �t^'�lr,2r � Si)izH�/ �Nti?�'�4/ (G727 e�/,+�i-'�L DiZ 1C�JZG� �1z�SrG�o��9 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> /��r�_>T���So�ic� �n'� <br /> CONTRACTOR G �"t"tL C' G�A�� pDDRESS ZIP CONiR.LICENSE 1t <br /> �ul�- <br /> PHONE <br /> PROPOSED USE OF BUILDING I Building fl Mechanical Addition HEAT SOURCE <br /> PERMI7 Combination �_� Plumbing 1YORK AlteraUon 'y�-(� Electric <br /> SiN(�lC J-N�''` �'f � n'PE Demolition v Sign 1YPE New �-( Gas <br /> Sprinkler Repair/Maint. LJ Other <br /> CONTRACT PRICE OF WORK f�I�C�G,, G�^ CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> WORKDESCRIPTION f{��j�j��,_ �;��1y/ C�lili/�L��' Ct�I S�Cc77'J Si/� _F l3f- lYCC�tSc'' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> BATHTUB FORCED,41R SYSTEM5 <br /> LAVATORY(WASH BAS�N) HEAT PUPAP <br /> i SHOWER UNITHEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HQOD <br /> LAUNDRY TRAY WATER H1=ATER <br /> CLOTHES WASHER METAL FIF2EPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREI�LACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOPIETC.) EXHAUST FAN <br /> OTHER OTHER_ <br /> I HERE6Y CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICAI,ON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF WORK 6VILL BE COMPLIED WITH WHETHER SPECIFIED FiEREIN OR <br /> t�OT. THE GRANTING OF�PERAIIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTFIER <br /> STATE OR LOCAL LAIN REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OIVNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITN THE STATE <br /> CONTRACTORS LAW 78,'_7 RC4V AND 96200 WAC. <br /> i /Z'� ' <br /> ���._-�%� � L` -- � ' _� <br /> Sigrfature ot OwnedContraC'todAuthonzed Agent Date , <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED /� <br />