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� <br /> PERMIT APPLICATlON <br /> CITY OF EVERETT' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �2iU{��� <br /> 425-257-8810- FAX 425-257-8857 � <br /> SITE ADDRESS I - ��' � PARCEL TAX I.D.N PERMI7 p <br /> i 3� T�:v�-��-�-e-rz F�E 4�?'5 Z47v i i cn ?�35'sL4�ouo� p3 -OQ(o <br /> LEGAL LOTNO. BLOCK TAACT <br /> DESC. <br /> OWNER - ADDRE S ZIP PHONE <br /> �o� ����.x� G��.n�� ►uE-nicn� :pa �.�x loC�� q�2�� 4z533q-3�58 <br /> c,�:,-rc--2. <br /> TENANTNAME CONTACTNAME PHONE 4 �5 <br /> � Cul�tC� ��nncs��f�tiO�e� ¢LS 33S � <br /> CONTRACTOR ` ADDRESS LP CONTR.LICENSEN <br /> Ann�i�, SPcz���u�-tZ, CkRP 231 � 153RA AV� S�- �`'jc�1U A��IS�`1n�C� <br /> PHONE <br /> 42S 335 -�(aa-� <br /> PROPOSED USE OF BUILDING 8uilding 60 Mechanical Addilion HEAT SOURCE <br /> PERMIT � Combinalion �� PlUmbiny WORK � Allomlion � Eleclric <br /> �'��G/�-�. TYPE Demolilion �� Sign TYPE New Gas <br /> Sptinkl0r RepairlTdeinl. Olher <br /> CONTRACT PRICE OF WORK Z—,�, gL� ��' CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> WORK DESCRIPTION , � ' <br /> , �,Lu_��,L 'JU ;���<,-,—,rv� �P2i�v�c��rz �svt�t�TS ��sZ t�E-�c q- 1� <br /> PLUNIBING MECHANICAL <br /> NO. TVPE OF FI%TUHE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> W�TER CLOS[T NC—A/HANDLING UNITS <br /> _ B�TIiTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEAT[RS <br /> K�TCH[N SINK 8 DISPOSAL CLOTHES DRYER <br /> DIStiWASHER RANGE 1�100D <br /> LAUNDRY TRAY WATER H�ATER <br /> CLOTIIES WASHER METAL FIf1EPLACE/STOVE <br /> URINAL FIREPL�CE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> f-LOOR DRAIN GA;: RANGE <br /> BACKFLOW PREVE�TER GAS PI�ING <br /> SINK (SERVIC[/0/1fi/MOP/ETC.) EXHAUST FAN <br /> OTI-IER OTHER <br /> I HEREOY CERITIFY THAT I I1AVE READ AND EK�MINED THIS APPLICATION AND KNOW TH[SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAN�S AND ORfD1NACE5 GOV[RNING TIiIS TYPE OF WORK WILL BE COMPLIED WITH WHETHEF SPECIFIED fiEREIN OR <br /> NOi. TIfE ANTING OF A PEfi IT OOES T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTIIER <br /> STATE O LOC�L LAW REGI��ft ING CO TRUCTION OR THE P[RFORMA CE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> YNER F�THIS PROPE(iJ[�O PERF M THE WORK FOR WHICH APPU ATION IS MADE AND I COMPLY WITH TNE STATE <br /> .JNTR�ORS LAW 1C.�flCW AN[I 6.200 WAC. <br /> � � - 3 /r � <br /> Sign lure ol Owned untracl /Aulhorized Agp Dale � Z I <br />