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APP.-19-2�Oo 13�59 FROPI:PER!•1IT 4257756315 T0� 142�2578857 P. 1 <br /> E cRMIT APPLICAT�.�N <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRF_ET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRE55 p� PARCEL TAX I.��D�/� rn�'CDO�-I'U7�� <br /> Z o b `I �pClc2-�/�Oi- d0 3 � c-�� <br /> IEGAL LOTNO. BLOCK TRACT <br /> DESC.I <br /> OWNC•R AUI]RE55 ZIP PHONE <br /> 1�-e h -fC� Zoo g �rx�e�l� �l/�Pi�.e�'1L <br /> TENANT NAME CONTACT FOR PERh11T PHONE <br /> �!`u �� ,�-��a d� yzr 2��- 8 �5� <br /> CONTRACTOR � � ADDRESS 21P CONTR.LICENSE N <br /> W RJ',H �1�� �V1C�J a�� ' k� ti) C�/5�J'�l��.19��Qg <br /> PHO�� '-'D L �w � � � _ '� ���y <br /> PROPOSED USE OF UUILDING 6uilding �j Mechanical �Addiqon I HEA750URCE <br /> /' PER�d1T Combination ��Plumbing WORK Alteratlon ,f��y Eledric <br /> J �'� 1YPE DemOliGOn LJ Si�n TYPE New �j Gas <br /> Sprinklor Repa�rR•7oint. U Other <br /> CONTRACT PRICE OF WORK C� DO� r GIN OF[VERETT LOCAL SALES TAJ(CODE IS J105 <br /> WORK DESCRIPTION <br /> �'�s GU��-,-1��-� �l� ��� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF�IXTURC OR ITEh1 NO. 7YPE OF FIXTURE(�R I7'Eh7 <br /> WATER CLOuET(TOILET) A/C-A/HANDLING UNITS <br /> BA!H I U8 FORCED AIR SYSTEMS <br /> _ LAVATORY (WASH BASIN) HEAT PU�ciP <br /> SHOWER UNIT IiEATERS <br /> KIl'CHEN SINK ti DISPOSAL CLOTHES DRYER <br /> DISHINASHER RANGF. HOO� <br /> LAUNDRY TRAY � WATER HEATER <br /> CLOTH[S WASHER A1ETAL FIREPLACE/STOVE <br /> URIPlAL FIREPLACE INSERT <br /> DRINKING FOUNTAI� GAS FIREPLACE <br /> FLOOR DRAIN ^ GAS RANGG <br /> BACKFLOIN PREVENTER GAS PIPWG <br /> � SINI<(SERVICE/BAR/A10P/ETC.) EXHAUST FAN <br /> OTH[R OTHER <br /> — — <br /> II HEREB7' CERIIIh1' I HAI I HAVE READANU E41f.tINED THIS APPLIC.4710N AND KWO�l'THE SA�'E TO BE TRUE AfJD GORRECT. ALL <br /> PROVISIONS OF LAW S AND ORIDINACES GOVERNING THIS T1'PE OF N'ORK 11'ILL BE C01.1Pl.lED VdITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THc GRl�NTING OF A PER1.11T DOES NOT PRESUM1�E TO 61VE AUTHOR!N TO VICLATE OR CANCEL THE PROVISICN OF ANY OTHER <br /> STATE OR LOC�L LA1'J REGULATING COIJSTRI�CTION OR THE PERFORtdAKCE OF CONSTRUC710N. THAT I Ald AUTHORIZED BY THE <br /> OWNER OF THIS PROPERil'TO PERFOR61 THE N'ORK FOR WHICH APPLICATION IS MAOE AND I COMFLY WITH THE STATE <br /> CONiH CTORS LA` .27 RGW AND 296.20 ' <br /> c�.�:�[�. �- w� � �c� � �9 OCp <br /> Si at re of Owner/Contractor/A i nzetl Agent Date I <br /> �_ DEBIT & CREDIT CARDS ARE NOT ACCEPTED _ j <br />