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PERMIT APPLICATI�N <br /> �.� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98207 <br /> 425-257-8810– FAX 425-257-8857 <br /> SRE ADDRESS PARCEL TAX I.D.1 <br /> v�O �r '1 PERM � <br /> �� .0 Z-�.S <br /> LEOA LOiNO. BLOCK TMCT <br /> DESC. <br /> OWNER ADDRESS <br /> ZIP PMONE <br /> TENANTNA E .L,� <br /> rS1k. �M,� Na,N� a,p��cf I CONTAC7NAME PHONE <br /> ���u Smfh ���38�-0�Zy <br /> coKrnacron Frit � ,M.� <br /> 6WtM► �nL. ADDqE33 PD aDX I��� aP CONQTR�•�UCEQNSE1R, <br /> PHONEC%ZSJ�O� �IZ� �U�+"S�i,�D�ZI�� <br /> Ctresif� Fr�s,GlA P,�SL <br /> PROPOSED USE OF BUILdNG Building ��r))) Mechanicel <br /> A���� HEAT SOURCE <br /> OJf;,o PERMIT R Combinallon � Plumbtng WORK �Altera�bn <br /> TYPE �ki Demolilfon 518� TYPE Naw � ��� <br /> �" Ges <br /> _ �aSprinkler RepaU/Maint. p�ry�r <br /> CONTRACT pRICE OF WOqK�/2�Z3 CITY OF EVERETT LOCAL SALES 7A%CODE IS 3106 <br /> J <br /> WORK�ESCRIoTION ��,{( j�Q ��y,� -� n�}_,. i �� � �h��u��. <br /> �fy....� <br /> �S��lc'��� <br /> ' PLUMBING MECHANICAL <br /> N0. TYPE OF FlXTUHE OR REM <br /> NO. TYpE OF FlXTUpE OR ITEM <br /> _ WATER CLOSET <br /> _ BATHTUB — aC–A/HANDLIN(i UNITS <br /> _ IAVATORY(WASH BASIN) _ FORCED AIR SYSTEMS <br /> ._ SHOWER _. HEAT PUMP <br /> ._, KITCHEN SINK 3 DISPOSAI .— UNIT HEATERS <br /> _ DISHWASHER _ CLOTHES DRYER <br /> _ LAUNDRYTRAY _ AANGE HOOD <br /> ._ CLOTHES WASHER _ WATER HEATER <br /> _ URINAL _ METAL FIREPLACE/STOVE <br /> _ DRINKING FOUNTAIN _ FIREPLACE INSEHT <br /> _ FLOOR DRAIN _ dAS FIREPLACE <br /> _ BACKFLOW PREVENTER — QAS RANGE <br /> _ SINK(SERVICE/BAR/MOP/ETC.) — GAS PIPINa <br /> _ OTHER _ EXHAUSTFAN <br /> _ OTHER <br /> —I — <br /> I NEREBY CEHITIFY THAT 1 HAVE READ AND EXAMINED TkIS APPLICAT7UN AND KNOW THE SAME TO BE THUE ANO CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNIN6 THIS TYPE OF WORK WILI BE COMPLIED WITH WHETHER SPC�IFIED HEqEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTliJqITY TO VIOLqTE OR CANCEI THE PROVISION OF ANY OTNEH <br /> STATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, i rtq f I AM AUTHOR¢ED BY THE <br /> OWNEH OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTRACTORS tAW 18.27 RCW,IqNU 2982p0 yyAC. <br /> �n �m, k,n 5� r�� 1 �- z� OZ <br /> S'g081ute�il�' .C��„�....w�iAu honzad Agenl <br /> ele <br /> �Z <br />