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� � P�RMIT 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 I.D.# P�ERM�T.ft� , /-0 <br /> zGi/ ti lp E��er L✓ VI/1��4�F <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PFiONE <br /> 13��5� �tr� 2Gl� ��P�e �vPie� �iBZo) (vzs)z5L-o�-tl <br /> TENANT NAME � CONTACT FOR PERMIT PHONE <br /> .�/,�s�, ��P� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> SPn� c� fP/ViCr,S/ShU CYf1�y �-z5 'YN�� /�i.e. � sPh:osSzy3aN <br /> PHONE / ,,.,y,r,��rpo `�5rz�5 <br /> PROPOSED USE OF BUILDING I7 Building I7 Mechanical Addition H T SOURCE <br /> PERM17 K Combination `H Plumbing WORK R Alteretion � Elecvic <br /> TYPE �._( Demolition L� Sign TYPE D New Gas <br /> U Sprinkler U RepaidMalnt Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION /�p7' U�To/ j��,n[ �rPlAce,•-rn7' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) AIC—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNITHEATERS <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 FOUNTAIN GAS FIRcPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BARIMOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> � <br /> I HEREBY CERITIFY THAT I HAVE READ AND E.XAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. TI1E GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TIiE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF TI11S PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAC ORS LAW 18.27 RC ND 296.200 WAC. <br /> i <br /> naWre of ned tractodAu 6nzed Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />