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. � <br /> �ERlVjIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EV[RETT, `NA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 Pw ��_ 3�- ; <br /> SITE ADDRE55 PARCEL TAX I.D.� PE IMi'T�: � <br /> ?�3a - _�,c� �l �0.Pa z� c,o3qao-c,�c, -u � -y ol �`��" !77 �, <br /> LE�J�.LI LOT NO. BLOCF TRACT � <br /> oesc j-y� �P.��.ca. <br /> OWNER ADDRESS ZIP PHONE , <br /> cAa�(L��2�s es L�..� 1 i o�a- 3 s�a� e s t w'#'k�l� �i�io t�• 4a.s��3 'I <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> (.,.y� l..�s�l� '�as - �43 -�`t c8 I <br /> CONTPACTOR ADORESS 21P CONTR.LICENSE# <br /> I�-c.�c�l2 CdL-�-�1J�tsa7� Ll_C.. �Zo�a-3s�A�eSE P�o-�h*� gFN��- A9f1-TQ��-63T�k <br /> PHONE -- �I <br /> PROPOSE�USEOFBUILDING �uilding echanical Addilion HEATSOURCE I <br /> S`���� $__ �, ( „ PERMIT Combination �lumbin� WQRK Aleration Electric <br /> u•nn.....- <br /> ��� TYPE Demolition U Sign TYPE ew 3as I <br /> $prinkler RepairlMainL Other I <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> WORK DESCRIPTION I <br /> ���..� �L c��\�., .�'Q.u,..A� �,�+x�- ��jdn�.e�-tt a:l b o -A <br /> PLUMBING MECHANICAL <br /> NO. I NPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM I <br /> i <br /> � WATER CLOSET(TOIL6T) AiC-NHANDLING UNITS ' <br /> I 11. BATHTUB _L FORCEU AIP,SYSTEMS I <br /> �-� IAVATORY(WASH BASIN) HEAT PUMP ; <br /> SNOWER UNIT HcATERS '� <br /> � �� ;rHEN SINK 3�ISPOSAL _� CLOTHES DRYER � <br /> _L :HN�ASHeR RANGE HOOD , <br /> LAUNDRY TRtiY �_ WATER HEATER <br /> � CLOTHES WASHER _ METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKIMG FOUNTAIN � GAS fIREPLACE � <br /> FLOOR DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER � GAS PIPI�G , <br /> SINK ISERVICEiOAR/MOPlETC.) EXHAUST FAN <br /> OTHER _ OTHER , <br /> _i — <br /> —� - — <br /> _i — <br /> ti=RE3Y CERITIFY THAT I HAVE RE.4D AND E.YAIdINE�i HI£APPLICATION AND KNOW THE SAME 70�E i RUE AND CORRECT. ALL I <br /> '?GVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK IYILL BE COMPUED WITH 1NHETHER SPECIFIFD HEREIN OR <br /> '�IOT. '!-E GRANTING OF A PERMIT DOES VOT PRESUME�O GIVE AUTHORITI' TO VIOWTE OR CA�JCEL THE PROV�SION CF ANV OTHER <br /> — —c JF L^CAL�AN'R°GJLATING CONSTRUCTION OR TNE PERFOR�dANCc OF CCNSTtiUCTION. THA i I AM1",.1UTNUF:�ED BY-HE <br /> - ..�•._��`,F-H15 PROPERT`.'TO PERFORId THE WORK FOR 1NHICH APPLICA i ION i_'�I�.1'vUF%•.ND I COISPLV`;VITH TH�STATE ' <br /> .;;:�;d,yRACTORS l.A1V 18.�7 RG'.V AND 256_'00 WAC. <br /> �`' l�l �4��oy <br /> =��nature �r O:meoContractor.- +w�onzed Aqen Date i�� <br /> E31T 3� CREDIT CARDS ARE NUT ACCEPTED <br />