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{�- <br /> P RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.M P MiT# �. / <br /> SOGu S�`14Nu1�lG Z� 29a (oe ,i �2ozYou ��-Z-�1 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �lc.�N¢7 � ��MX'rc,(I k I/�fNcE S�aoo S't'Nl1Hiz1P"At�t' L-Vt7iCFfT W.d �Z°3 <br /> TENANT NAME CONTACT FOR PERMIT PNONE <br /> M,c+,n�t ,7" �p,ry,z�r;,� ,t l�.gWcc i�,cr�'t- J v.t�v� YZf�- y��-s�'7Y <br /> CONTRACTOR f'�` ADDRESS 21P CONTR.LICENSE N <br /> PHONE <br /> Yz�- y/l- -�f37y <br /> PROPOSEDUSEOFBUILUING pERMIT f� �P nk'leation �j Plu bngal WORK Nteratlon HEATSEBRWC'E <br /> L �Vr�'t4 7ypE �__� Demoiition U Sign TYPE New Gas <br /> d LJ RepairlMaint. �Othar <br /> CONTRACT PRICE OF W ORK L/S 0 Q p `�/f� CITY OF EVERETT LOCAL SALES TA7(CODE IS J105 <br /> WORK DESCRIPTION <br /> f� r�,,/ �itG�f - QLIxS� � 'a�v <br /> /1�� l � ,f�l'y - /�'�7-SF� z- � � <br /> Z 3�- > 3 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-AIHANDLING UNITS <br /> ,�, BATHTUB _ FORCED AIR SYSTEMS <br /> T LAVATORY(WASH BASIN) HEAT PUMP <br /> � SHOWER _ UNITHEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRti'ER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I 4AVE RE.A�AND E%AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND i)RIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE C�.%.�1TING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORM1IANCE OF CONSTRUCTION. TFIAT I AM AUTHORIZEO BY THE <br /> OWNER OF THIS PROPERTY TO PERFORA1 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LA 78.27 RCW AND 296.200 WAC. <br /> �`, �':�- ���q� <br /> SignaWre of wnedContractor/Authonzed Ag�nt ' Date I <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED rZ <br />