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— -- � --- � - - --- <br /> �I PERMIT APPL[CATiON <br /> � 3 �` GI CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982D1 <br /> 425-257-88�a — FlilC 425-257-8557 <br /> 5 - �0-13 <br /> SITE ADDRE55 � PARCEL TIllC I.D.k P[R1diT u <br /> � 7 �� <br /> I ✓i�t I �05 - �5a I <br /> LEGAL l0T 40. I BLOCK TRACT <br /> DESC. <br /> OIYNER ADDRE55 ZIP PHONE <br /> AL r-Q- �!6��� S//7 v��w O.� F_L.�r� ��4 �. �isq-�s�i i <br /> TEN.IVT NAL1E CONTACT FOR PERh11T PHCWE <br /> �.Qs/i � v�3 �- y0u9 <br /> CONTRAGTOR n7pP�Yf //b�/Jl7N(n ADDRE55 L{7/7 �7T-Y f�C�� ZIP CONTR.LICENSEiI <br /> �` q NE K�LL � �.•' R �u�,P.Osr�R�r>s'fCH � <br /> PHONE y(_',S`'3e�J 'y4Z/ 9.�L7o <br /> PROPOSE�USe OF BUILDING I � BuilCir�g ��!echanical AdCition HEAT SOURCE <br /> PERh117 Combination Piumbing WORK Alteratioo �Eleanc <br /> s�,v(�E �ON�Gy T'/PE Demolili0n � Sign TYPE Ne�.v Ga. <br /> � Sprinklef Rcoahrtda��nt. Olner <br /> � CON7RACT PRICE OF WOR /' � �OZ� OD I CITY OF EVERET'f LOCAL SALES TA%CO�E IS 3105 <br /> C.Q <br /> IV70RKDESCRIP710N <br /> � �D�O HFRi PcLi,'P 7-t� F�is%�n�G Gq5 F.��ro�E � <br /> ( <br /> � <br /> PLUA161NG MECHANICAL <br /> NO. iVPE OF FIXTLRE OR 17EM NO. NPE OF FIXTURE OR ITEA7 <br /> WATER CLOScT (TOIL�i) _ a'C—AMANDLING UNITS <br /> BATHTU9 FORCED AIR SYSTEA"S <br /> L.4VAlORY (WACiH BASIN) � HEAT PU�1P <br /> SHOW[R _ UNIT!-.EATERS <br /> KITCHEN SWt:R DISPOSAL CLOTHEo CRYER <br /> OISHIh'ASHER R�NGE HOOD <br /> �4UNDRYTRAY _ VJAT[RHE/1lFR <br /> CLOTHES:NASHER h1ET.4L FIREPLACE/STOVE <br /> VRitvAL _ FiREPLACE INSERT <br /> DRINKING OUNTAW _ GAS FIR[PIACE <br /> FLCCR DR.+tN GAS RANG[ <br /> BF.CKFLOW PREVcNTER _ GAS PIPING <br /> SINK(SERVICEIBAW1.90='ETC.) _ EXHAUSTFAN <br /> OTH[R _ _ OTf-I�R __ <br /> 1 HEREBY CEFITIFY THA71 H4l'E RE40 AND E?:AId�NED iHIS:.PPUCnTION.4hO KNGVJ THE SAb1E TO(3E TRI:E AND CORRECT. �LL <br /> PROVISICNS O� LrVJS AND ORIDINACES GO�if_R�iNG THIS NPE OF WORK WILI BE COAIFLI[D b'diT�.WHETHER SPECIFIE�HER[IU OR <br /> �.uT. THE GRAtJTING OF A PER.\'IT COES NCT PRESUI.SE TO C'VE AUTHGRITY TO VIOI�:TE OR GHNCEL THE PROVISIOW O=4Nv OTHER <br /> SL4TE 03 LOCSL LA�V REGGLATI?1G CONSTRUC710N OR THE PERFORN�NCE O�GON5T3UCTION. 'IiAT I AM AVTHO�41Z[D DY THE <br /> OV/NER ETHiS PRCPEP,iY TO PERFO,t�.1 TREYJDRK rOR WHICH AFPLIC.4T�ON IS hii�L',`F.4ND � CO�\cPLY WITH THE STATE <br /> C0� C qRS li.'vV ib..'7 RC�+V AP1D 295._00:YAC. I <br /> ��� s-3o� /,� I <br /> " naWreol vnerlContractor/AuthonZedAgenl ���� <br /> DEBIT 8 CREDI7 CARDS ARE NOT ACCEPTED 'I <br /> � d �;�. �. i c,� nc .<��,; <br />