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i _ - — - — -- <br /> P�r�MIT APPLICATI� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE'TT, WA 98201 � <br /> 425-257-8810- FAX 425-257-8857 � ���_ Or� <br /> SITE ADDRESS � PARCEL TAX I.D.A PERMIT M <br /> O� N� .E � c�3p7- �!7 <br /> LEGA lOTNO. BLOCK TRACT <br /> OESC. Lr � �i S/�/r'D[ �/ �C�Si+�^ T�/7GT� ' <br /> OWNER A�ORESS / ZIP PHONE I <br /> � ,�ti���� ��_ /�.., -5, T -�.Z9-[.�-rtia���in /=u z�-rr 9B.zq -<l,,2t 33?-90?`i <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> Sr��c-ai4z�n�� �542�' 3.3?- 90?9 <br /> CONTRACTOR S'��L � �7;�� AODRESS ZIP CONTR.LICENSEN � � <br /> PHONE <br /> PROPOSED USE Of BUILDING I Building D Mechanlcal Addilbn HEAT SOURCE <br /> PERMIT � Combinalion U Plumbing WORK �Alle�alion � Eleclric <br /> TYPE Demolilion U Sign TYPE New Gas <br /> 5�'F� Sp�Inkler RepalrlMalnl. Olher <br /> l� <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> WORK UESCRIPTION . . . <br /> / / ` I <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM. , <br /> � WATER CLOSET(TOILET) A/C-A/HANOLING UNITS <br /> BATH7UB � FORCED AIR SYSTEMS , <br /> � IAVATORY(WASH BASIN) _ HEAT PUMP <br /> � SHO�VER UNIT HEATERS <br /> � KITCHEN SINK 8 DISPOSAL ,� CLOTHES DRYER <br /> � DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> � CLOTHES WASHER _ METAL FIREPLACE/STOVE � <br /> URINAL FIREPLACE INSERT i <br /> _ DRINKING FOUNTAIN GAS FIREPLACE � <br /> FLOOR DRAIN GAS RANGE <br /> = BACKFLOW PREVENTER � GAS PIPING i <br /> SINK(SERVICEfBAR1MOP/ETC.) �, EXHAUST FAN <br /> OTIiER OTHER <br /> — — f <br /> i <br /> 1 HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIOINACES GOVERNING T�'�S TYFE OF WORK WILL BE C�MPLIED WITN WHETHER SPECIFIED HEREIN OR <br /> t10T. THE GRANTING OF A PERMIT OOES NOT PRESUh1E TO GIV[AUTHORITY TO VIOLATE OR CANCEI THE PROVI5101�OF ANY OTHER <br /> STATE OR LOCAL lAW REGUIIQING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICIi APPLICATION IS MADE AN01 COMPLY WITH THE STA7E <br /> CONTRACTORS W .27 RCW ANU 2�96 200 WAC. <br /> t/i� '�- `�`O� <br /> Si ot ner/ContraclorlAu�ze �{gent Dale �-,.\ <br /> DERIT & CREDIT CARDS ARE NOT ACCEPTED 1�Z <br /> � <br />