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RPR-4-200r 11:48 FROM: TO:1A252578857 P.1 <br /> i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 982�1 <br /> 425-257-8810—FAX 425-257-8857 <br /> SITE qpDRESS , / PARCEL TAX I.D.N PERMIT M <br /> S� j � l/ (-GCc) �✓ Z'aO�PGf`1 r�0�$oU / " _2 <br /> LEG LOTNO. BLOCK TRACT <br /> DESC. <br /> � • A�ORESS ZIP PMONE <br /> s <br /> l��C4h S �zberf �r l� ✓�ti 0,� �c,�.¢f- (.�J� �j'�za3 zs4-�(�T <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> .s�� � ,�nd�. yzs- � �o �� <br /> CON CTOR �s�� (�n wn jn� ADDRE99 LIP GONiR.LICENSE/ <br /> (�(�'�f{� Z �rAY/crJ /J � /� �p <br /> PXON'� �Z �� � � �t k'Q./T(!G�N Il �"I�.J�p?I��C7 <br /> �v((/ 'L(f� <br /> PROPOSEDU3EOFBUILDING Bulldl�ig Mechanlca� Addl�on I HEAT90URCE <br /> S�� PERMI7 BCombinadon Piumbing WORK AlleroUon ElecWc <br /> TYPE B Demolillon Slgn 7YPE �New �Gas <br /> Sprinkler Repair/Meint. Olher <br /> CONTRACT PRICE OF WORK � Z22 V V CITY OF EVERETT LOCAL SALES TIVC CODE IS NOS <br /> WORK DESCRIPTION / / <br /> � 1 � � ��'t� COyI U�/'.f!UK. �(1.$7 i(! /!2� 0'Y(4C� <br /> Q�lc� �-1,�.�r ��.-�r L,�� 9�1 /�r a r v�� <br /> '�uvvt�.ce - Gjv ovo ,(�{v� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FUCTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET(TOILEn A/C-AIHANDLING UNITS <br /> _ BATHTUB = FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEA7ERS <br /> _ KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> _ DIBHWASHER RANGE HOOD <br /> _ LAUNDRY TRAY = WATER HE-ATER <br /> CLOTHES WASHER METAL FIREPlACE1STOVE <br /> URINAL FIREPIACE INSERT <br /> DR�NKING FOUNTAIN (;AS FIREPLACE <br /> _ FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � GAS PIPING <br /> _ SINK(SERVICElBAR/MOP/ETC.) EXHAUST FAN <br /> _ OTHER _ _ OTHER <br /> I Hc'REBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATICN AND KNOW TNE SAME TO BE TRUE ANO CORRECT. ALL <br /> PROVi510NS OF LhWS AND ORIOiNACES GOVERNING TMIS IYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUTATING CONSTRUC710N OR TliE PERFORMANCE OP CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE, <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br /> CONT CTORS tA471s.27 RCW AND 298.20 �!�/d <br /> �j�/�!�'a�����ovvt�c� � L .t� <br /> SI f at re3 o�Owner/Contractor 'i nzed Agent -6ale <br /> DEBIT 8 CREDIT CARpS ARE NOT ACCEPTED <br />