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�PERMIT APPLICATION <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 f.D.# P RMiT k <br /> ;��IS l'✓1e ��II Cree QK�� OZ 2 0 � oa� oG o� �30�-�33 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AUDRESS ZIP PHONE <br /> C��;.Nn�� ` ;2 �2r5 /�u,efrlll Cr�¢k. ('kw,� 98zo3 �4�s'�z� -lov�� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �T.�T C�;reless S�rU�ee;S ( L(av� G�v�e, (��310 3�O�f <br /> CONTRACTOR � ADDRESS ZIP CONTR.LICENSE# <br /> PHONE �GC��/ l�f i/'�r�'�• �'I ��i �S� '-7�II �j �j�j 6 I�� I <br /> 4 <br /> PROPOSED USE OF 6UILDING � Building D MeChaniCal Addilion HEAT SOURCE <br /> �� PERM�i Combina�ion U Plumbing WORK � Alteration f� Electric <br /> �.fQ,���SS ����III11Uili�dh T.pF. Demolition U Sign TYPE New � Gas <br /> ���L�' � �-, Sprinkler RepaidMaint. Other <br /> CONTRACT PRICE OF WORK ` ��� � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> v <br /> WORK�ESCRIPTION `v_(pW, ;�\ O�" u1N�C11i10-S OVl ��5 �h�y ���1(�I'1� C���. Wl <br /> e��o & e(ec:�'�ro�� ;� �r.� p�mwn�- t�n Ca�;nt.� ��" i'l.x, �.Sz o� -N�e p�l�,. <br /> PLUMBING MECHANICAI. <br /> NO. TYPE OF FIXTURE OR ITEM � �' NO.. TYPE OF FIXTURE OR ITEM N A <br /> WATER CLOSET(TOILET) _ A/C-AIHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&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 <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTIiER 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 OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. TIiE 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 PERFORA7ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROFcRTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS 18,27 RCW AND 296.200 WAC. I <br /> �` �C.-�-2_ 7�3i�Cj3_ //'\ <br /> �fG ' J <br /> SignaWre of OwnedContractodAuthorized Agent Date ��2 <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED i <br />