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SITE ADDRESS �� <br />I PARCEL TA`( I.D. M <br />I PERMIT M <br />LEGA LOT N0. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER � � / ADDRESS ,/ ZIP PHONE <br />�s9- - <br />Jov�-t7 �i�l/C•` �V9sao� <br />/(/(a7�z ��D/ - 5�as <br />7 <br />TENANTNAM <br />CONTACT NAME PHONE <br />L�el/ ya5 / - s63 <br />CONTRACTOR ADDRESS ZIP CONTR. UCENSEA <br />92� <lg <br />PHONE�a S '�'�' " S3 i�-�f • JTt'G'e �f4 ��Cjr % 0.�6!`j. <br />PROPOSED USE OF GJILDINO <br />I--1 Building <br />AdditionHEAT <br />SOURCEPERMITCombinationlumbing <br />IPMechanical <br />WORK <br />Alteretion <br />Electric <br />5 I � <br />TYPE <br />Demolition Sign <br />Sprinkler (N of heads) <br />a: <br />TYPE <br />'p <br />lIR(( New <br />Repelr/Maint. <br />jj�{�� Ges <br />�=9 <br />LJ Other <br />CONTRACT PRICE OF WORK �QO rKi <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />1 <br />- <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR REM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) A/C - A/HANDLING UNITS <br />BATHTUB 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 />LAUNDRY TRAY � WATER HEATER <br />CLOTHES WASHER _METAL FIREPLACE/STOVE <br />URINAL FIREPLACE INSERT <br />DRINKING FOUNTAIN GAS FIREPLACE <br />FLOOR DRAIN GAS RANGE <br />BACKFLOW f'REVENTER GAS PIPING <br />_ SINK (SERVICE'@.4R/MOP/ETC.) EXHAUST FAN <br />_ <br />OTHER OTHER <br />I HEREBY CERITI FY THAT I HAVE READ AND EXAMINEE' HIS nPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />p...,.,.._......,.�..,.r,:.R.......,:...s;xax-.:Y.ra:,;�::°..:a.. it <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATEOR LOCAL LAW REGULATING CONSTRU TION OR THEPEHrORMANCE CF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTYT ORM T WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTR �S LA(^)M 27 R .20 <br />Si a r o Owner/Con acto .4 tl Agen -- Date <br />i VA03 91- 0' <br />FcRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 —FAX 425-257-8857 <br />