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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 ; <br /> i <br /> I SITE ADDRESS PARCEL TAX I.D.# PERMi7: ' <br /> � II�Z�I ��� A-✓� Payd�- y � <br /> LEGA LOTNO. BLOCK TRACT j <br /> DESC. <br /> OWNER AD�RE55 ZIP PHONE ! <br /> ����� �yl� Cc,66✓.et Il�2�f R�cl�-r A,l.c ��� �$Lo� � <br /> TENANTNAME CONTACTfORPERMIT PHONE . <br /> ���;�� nc � Cc�6� r�c� /�evi�r ��Ysc,,� yz5- �5y - y�y5 ! <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# i, <br /> �.�- �It�-»16�n� , I wc. g� �v3�d �� u� r�S�� y s t� .rEr-�` � ,� o ��sEr , <br /> � rHor,e 3ao -�35 - 955,� � <br /> PROPOSED USE OF BUILDINu Building f'l MCChanical Addilion HEAT SOURCE I <br /> PERMIT Q{._j Combination k-� Plumbing WORK Alteration Q Elec:nc I <br /> % `('�.I . ..�� TYPE �.j Demolition �L Sign TYPE New �..j Gas <br /> K- a' u��"' L� Sp�inkler Repair/A7aint. U Other I <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' <br /> WORK DESCRIPTION 'I <br /> I <br /> PLUMBING MECHANICAL i <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM � <br /> WATER CLOSET(TOILET) FVC—A/HANDLING UNITS � <br /> BATHTUB FORCED AIR SYSTEMS I <br /> LAVATORY(WASH BASIN) HEAT PUMP ' <br /> SHOWER UNIT IiEATERS i <br /> KITCHEN SINK R DISPOSAL CLOTHES DRYER �, <br /> DISHWASHER RANGE I100D � <br /> I LAUNDRYTRAY WATER HEATER ' <br /> � CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URtNAL FIREPLP.CE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> i � FLOOR DRAIN GAS P4NGE <br /> � BACKFLOW PREVENTER GAS PIPING <br /> I SINK(SERVICEiBAR/t�IOP�ETC.) EXHAUST FAN , <br /> I _ OTHER _ OTH[R � <br /> — — — , <br /> I <br /> ' I HEREBV CERITIFV THAT I HAVE REi.D AIJJ EXi+!�dINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL � <br /> � PROVISICNS OF L.1WS AND ORIDINACES GOVERNING THIS TYPE OF WORK'a1'ILL BE COA7PL:ED VJITH IVHETHER SPECIFIED H'tREIN OR , <br /> NOT. THE GRANTING OF A PERMI i DOES NOT PRESUME TO GIVE AUTHORITV'0 VIOLATE OR CANCEL THE PROVISION OF AIJV OTHER <br /> � STATE OR LOCAL LAW REGUL4TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I Ah1 AUTHOPIZED BY THE ' <br /> � OWNER OF THIS P�40PERN TO PERFO�IA THE IVORK r'OR WHICH APPLICATION IS A1ADE AND I COMPLY WITH THE STATE ' <br /> CONTRAC70RS LAW 1827 P,C'.V AND 2B'o..00 6YAC. ', <br /> � -ec�-� I�-CQ�- ►�2��0� ' <br /> ', Signalure o(OwnenConVactorrAuthonzed Agent �ate I <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED ' <br />