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PE_ �MIT APPLICATiO�. : <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS � PARCEL TAX I.D.k PERMI7 x <br /> 1• M DZG�-D 1�j <br /> � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PMONE <br /> , '��rr� Moo� 3�ra p i�L� ��,� �v . ���,�,�� qRa�.L <br /> TENANT NAME CONTACT NAME PHONE � <br /> CONTRACTOR GM ������ ADORC-SS I lf I S ����W(,�y 21P CONTR.LICENSE M <br /> J -/ � � ��� CMNcA1�09S2y <br /> PHONE yp�� 'aSq -�(1�{"�Y� <br /> PROPOSED USE OF BUILDING 8uilding � Mechanical Addition I NEAT SOURCE <br /> PERMIT R Cainbination Piumbing WOHK B Aneration � Electric <br /> TYPE D Demolitia� Sign iYPe IRNew Ges <br /> U Sprinkler U Aepair/Moint. Olher <br /> CONTRACT PRICE OF WORK /��O CITY OF EVERETT LOCAL SALES TA%C07E IS 3105 <br /> WORKDESCRIPTION C�GS � C1G�S ��1 'v�CQ �W1\'y�. - � <br /> u <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> WATER CLOSET A/C-A/HANDLING UNITS <br /> I _ BATHTUB _L FGFlCED AIR SYSTEMS <br /> . LAVATORY(WASH BASIN) _ HEAT PUMP <br /> i _ SHOWER _ UNIT HEATERS <br /> � KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> I _ DISHWASHER _ RANGE HOOD <br /> i _ LAUNDRY TRAY _ WATER HEATER <br /> CLOTHESWASHER _.. METALFIREPLACE/STOVE <br /> URINAL FIREPLACEINSERT <br /> �j _ DRINKING FOUNTl,IN � GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> . BACKFLOW PFEVENTER _ GAS PIPING <br /> SINK(SERVICE/BAR/MOP.�ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNUW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS O�LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTHORITY TO VIOWTE OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I.4M AUTHORI2ED B'Y THE <br /> OWNER CF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION I°�MADE AND I COMPI.Y WITH THE STATF <br /> CONTRACT LAW 18.�W A�Q�200 WAG I � <br /> Y\ � i3 �a <br /> Signalure o dwner/Contr r/Aut i�on d Agent Date <br />