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P��RMIT APPLI�ATIGN <br /> CITY OF EVERETT PERMIT SENVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRESS QQQ �^. ,�)� �/� PARCEL TAX I.D.N � PERMR� <br /> 7 rT'�1 !rv <br /> LEGA LOT N0. BLOCK TIIACT <br /> DESC. � <br /> OWNER ADDRE33 LP PMONE <br /> PEr►lC C/OD �C.iF�C. A�(�r <br /> TENANT NAME I CONTACT NAME PfiONE <br /> ►'�Ci�c.�!{ e.�.� n�Ic.. <br /> CONTRACTOR ADDRESS ZIP COHTR.LICFNSE II <br /> a�qYno�i� a caNs,RJ�,�oRs �./36 A,aP�¢T iltz ,�Mnor3eo�kt3 <br /> PHONE <br /> �3to0 -'73�('360o CRiirlCrllAW� 9b�Z2b <br /> PROPOSED USE OF BUILDING Building I% MeChanical I''1 Addition HEAT SOURCE <br /> PERMIT Combinetion p� Plumbing WORK bq(� Alteretton R Eiectric <br /> �/1����,/}�� �;f.l fJIG� TYPE Demolition �J Sign TYPE �j New �,.f Ges <br /> Sprinkler U RepaidMaint. Q� Ottier <br /> CONTRACT PRICE OP WOqK CITY OF EVERETT LOCAL SALEB TAX COOE IS�106 <br /> WORK DESCRIPTON <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FlXTURE OR ITEM NO. TYPE OF FlXTURE OR(TEM <br /> WATER CLOSET _ A/C—A/HANDLING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> � 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 /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTA�N _ GAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING /r /�� <br /> � SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN V <br /> OTHER _ OTHER <br /> — t� s G�OOV <br /> — �- = — ., �_ <br /> �-� �,�(a�;,. <br /> I HEREAV CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND OR�DINACES GOVERNING THIS TYPE OF WORK WIIL BE COMPIIEU WITH WHETHER SPECIFIED HEREIN OH <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 LO AL lAW FEGULATING CONSTRUCTION OP THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTMORIZED BY THE <br /> OWNER OF �5 P PERTY TO RFOPM THE WQRK FOR WHICH APPLICATION IS tdADE AND I COMPLY WITH THE STATE <br /> CONTR4 ORS 18.27 R AND 296200 WAC. <br /> � <br /> '�� Q�i <br /> Sign ture of Owner/Co tractor/Aut rized Agent ate <br />