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� P�t�MIT APPLICATI� <br /> CITY OF EVERETT PERMIT SERVICE�� <br /> 32('0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> 6-0 `� ` 0`� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# � <br /> Moyocc-c.lU <br /> i:Z�b 1�L �L"C, — ' <br /> LEGAL LOTNO. BLOCK TRACT j <br /> DESC. I <br /> OWNER ADDRE55 ZIP PHONc <br /> �cl�N 1L`�( �2Z6 I�It11'LE `�- �C���,I 1 '�vt-1 �A'Zu I �4'..�> �»-�; ��// <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR ADDRESfi ZIP CONTR.LICENSE# <br /> Ou%Ni:Y� <br /> PHONE ��:Z�> ��Q7�—��0� / <br /> PROPOSED USE OF BUILDING I� Building D Machanical Addition HEAT SOURCE <br /> PERMIT K Combii,ation u Plumbing WORK � Alteration �) Electric <br /> TYPE �( Demolition U Sign TYPE New � Gas <br /> U Sprinkler RepairlM;int. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SAlES TAX CODE IS 3�05 <br /> WORK OESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM , <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS � <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK&DISPOSA.L _ CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY _ VJATER HEATER <br /> CLOTHES N'ASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIRF.PIACE IMSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BAR/MOPlETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> i <br /> i I H°REBY CcRITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND NNOW THE SAA9E TO BE TRUE AND CORRECT. ALL <br /> � PROVISIONS OF IAWS AND ORIDINACES GOVERNING-HIS TYPE OF WOFiK\'JILL BE COAdPLIED N'ITH INHETHER SPECIFIED HEREIN OR <br /> � NOT. THE Gi2ANTING OP A PERMIT DOES NOT PftESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUIi.TING CONSTRUCTION OR THE PERFORAIANCE OF CONSI'RUCTION. THAT I A1.1 AUTHORIZED BY THE <br /> i OWNER OF THIS PROPERTY TO PERFJRM THE INORK FOR INHICH APPLICATION IS MAUE AND I COAIPLY WITH TNE STATE <br /> I CONTRACTORS LAW 1^8.27�2CW AND 296.20D N'AC. I�I �� <br /> I ✓ '`� � <br /> iSignature of Owner/Contr�etor/Authonzed Agent Date <br /> i DEBIT & CREDIT CARDS ARE NOT ACCEPTED I <br />