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P�RMIT APPLICATIGN <br /> � CITY OF EVERETT PERMIT SERVICES <br /> J'"" 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-^57-8810- FAX 425-257-BB57 <br /> SITE ADDRESS � PARCEL TAX I.D,k • PERMI7 ���/p <br /> O//g S' /.��2�v�= .�E /�A� 00396�o�aa,z gco �OS'S�' <br /> L[GA LOT N0. 5��BLOCK TRACT '/ � / <br /> DESC. Z /ZU�-OO�� �/co ���n=�t/['�4�-cL�C�S� T1.��eZ JN �6 �� wM• <br /> OWNEq ADDRESS ZIP PHONE <br /> /`ric:lqEL Q�'k.orn ��� �Z �uv,a�cr� ��0/5' lz�w�fr/9-��i3 <br /> TENANTNAME I CONTACTNAME PHONE <br /> CONJTRACTOR �! ,�ADDRESS ZIP CONTH.LICENSE M <br /> �,�C.uC �•a5E(.o.vs^. �e �f o•�x 3oZ /�uv4c; wA r7'SDi9 acuE RcT �i�'r6TT' <br /> PHONE � <br /> o�,� �9-� �3 <br /> PROPOSED USE OF BUILDING Building 6� Mechanical Addition HEAT SOUHCE <br /> S. PERMIT �Combinalion �� Plumbing WORK �Alteralion I D Electric <br /> ��^�4�� �'''���-y TYPE Demolition V Sign TVPE New �tGas <br /> '�ES Sprinkler RepairMleint. U Othe� <br /> CONTRACT PRICE OF WORK ��3 aQU ^ CITV OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> WORK DESCRIPTION / l ,/ <br /> �l�aJ (n��a� �2,4,�-,�' 95'auss /�SAsic ��v3� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF flXTURE OR REM <br /> � WATER CLOSET A/C-A/HANDLING UNITS <br /> �' BATHTUB T FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> � KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> � DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY I WATER HEATER <br /> / CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACEINSERT <br /> DRINKING FOUNTAIN � GAS FIREPLACE <br /> _ FLOOR DRAIN I GAS RANGE <br /> _ BACKFLOW PREVENTER �' � GAS PIPIN a <br /> SINK(SERVICFJBAFVMOP/ETC.) � EXHAUST FAN <br /> � OTHER OTHER <br /> I — — <br /> I IIEREBY CERI7I�Y THAT I HAVE READ ANO EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRU[AND CORFEGT. ALL <br /> i PROV1510,':5 OF LAWS AND OFIDINACES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUAIE TO GIVE.�UTHORI iV TO VIOIATE OR CANCEL THE PFi0V1510N OF ANY OTHER <br /> STATE OR LOCAL GULATING CONSTRUCTION OR THE PFriFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROP RN TO PERFORM THE ORK FOR WF'iCH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW�Br.2�W AND 296.� � <br /> � y <br /> SignaWre ol OwnedConlraclodAuthorized Agent Dale <br /> `(z <br />