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P�RMIT APPLICATIC�N <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 I.D.# PERMiT# <br /> — ✓J'(/Y.'ItiltP /` 0 �o—��{('� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PF10NE <br /> �ie�vr, I tti'�. 2�� _JyJo„uu <br /> TENAN NAME I CONTACTFORPERMIT PHONE <br /> '�}�.y. v��/GS- �f124 34S 47'S� <br /> CONTRACTORq� ADDRESS ZIP CONIR. LICENSEM <br /> PHONE�^ /��Gt�t,S 87/�-3/3�P/.fU.lv. �37� �f��fZtDy/!Cs <br /> y�5 -3�lS-c}'7�'3 . <br /> PROPOSED USE OF BUILDING f� BUilding D MeChanical Addition HEAT SOURCE <br /> PERMIT �_� CPmbination U Plumbing WOR�; B AltPration n Electric <br /> TYPE �( Demolition U Sign TYPE D New D Gas <br /> L� S rinkler U Re air/Maint. D Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TA%CODE IS 9105 <br /> WORK DESCRIPTION <br /> �� 1. � ^ C (,l�Gu/ <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO.. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) Pu'C—A/HANDLI�IG UNITS <br /> _ BATHTUB FOkCED AIR SYSTEMS <br /> _ LAVATORY(NlASH BASIN) HEAT PUMP <br /> _ SHOWER UNITHEATERS <br /> _ KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> __ DISHWASHER R,4NGE HOOD <br /> _ LAUNDRY fRAY WATER HEATER <br /> _ CLOTHES WASHER METAL FIREPLACE/STGVE <br /> _ URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br />� _ — <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 SPECIFIEO HEREIN OR <br /> NOT. THE GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOI.ATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LA6Y REGULATING CONSTRUCTION OR TFiE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROI'ERTY TO PERFORp'THE WORK FOR WHICN APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1B.2�RCW AND 296.200 WAC. <br /> "'.�.,��.f�'�+�.— /�3�rv <br /> Stgnet re of edContractodAuthonzed Agen: �Dat�— <br /> DEBIT 8� CREDIT CARDS ARE NOT ACCEPTED <br />