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,':.:- ,k,�C-L- <br /> PE..�MIT APPLICATIO. . <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, EVERETf, WA 98201 <br /> 425457-8810 - FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PEFlMIT# <br /> C� .?�,�� rrt� '�<< c P � r� c3 , —��c �C �� II - �'l �— <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS ZIP PHONE <br /> �l'�rv.,l\ (� :�t�L 1-�,.A.1�.���,a 1 l C �rc�� � lv��„r,�..�. J{. �� .�8,) _S:. �IIC, i.�/-1 `iS/0/ <br /> TENANT NA�dE CONTACT NA E PHONE <br /> Z���-v��c.�. C. ��r, �- r �'_v✓ a� S - `l:�G ..�Ji�' <br /> CONTRACTOR AD�RESS ZIP CONTR.UCENSEN <br /> �'� 3 ���b 3J 'i�• <br /> PHONE n <br /> PCo+i,i:�" f�.� I,���.c�io,� 7G�c �7i�� 76i��h�c. 1=' /�C �IS�/.il�� i✓.<)TK.I�i'l�u'j<, l F <br /> PROPOSED USE OF BUILDING Building ('1 Mechanical Addition HEAT SOURCE <br /> PERMIT Combination K Plumbing WoaK Auew�ion Q Electric <br /> TYPE Demolilion �_) Sign TYPE New �J Gas <br /> �., . Sprinkler Repair4dainc L.� O�her <br /> n �r v � ,u_�1 <br /> CONTRACT PRICE OF WORK `� �I c`Y �`�` CITY OF EVERE7T LOCAL SALES TAX COOE IS 3105 <br /> l <br /> WORK DESCRIPTION <br /> � <br /> I�� � I rc� ic S :� � � n ,t< � .-�i,. �- - <br /> PLUMBING, MECHANICAL � <br /> NO. TYPE OF FlXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM I <br /> WATER CLOSET A/C —A/HANDLING UNITS <br /> I _ BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATOFiY (WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DiSPOSAL CLOTHES DRYER <br /> _ DISHWASHER RANGE HOOD � <br /> I.AUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER MET�L FIREPLACElSTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FlREPIACE <br /> F100F DNAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PI?ING <br /> SINK (SERVICEr'BAR/MOPlETC.) EXHAUST FAN I <br /> � = OTHER = OTHER I <br /> � � <br /> i HEREBV CERITIFY'HAT I HAVE AEAO AND E?CAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE.4ND CORRECT. A�L � <br /> PFOVISIONS CF WWS AN�ORIDINACES GOVERNIN�THIS TYPE OF WORK WILL BE CGMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> 'JOT. THE GRANTING OF A PEFMIT DOES NOT PRESUhtE TO GIVE AUTHORIIY TO VIOLATE OR CFNCEL THE PFOVISION OF ANY OTHER I <br /> �'iTc OR LOCdL LAW REGUL4TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 6Y THE � <br /> lER OF THIS PROPERTY TO PEAFORM THE WOFK FOA WkICH APPLICATION IS MADE AND I COh7PLY WITH THE STATE <br /> TFACTOFS WW 10.27 FCW AND 296.200 WAC. �� <br /> /� i <br /> L�i��tc.. /�1c /L %/�/S �d`/ . <br /> Signawre ot vneUConlracror/Aulhorized Agent Date � i <br /> ` L <br />