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( ( <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9P201 <br /> 425-257-8810—FAX 425-257-8857 <br /> SITE ADDRESS ARC L TAX I.D.• P RMiT� <br /> S Zoz Sr.p.�i�� 00 3� OGb Da�Z 03 <br /> LEGA LOTNO. SLOCK TRACT <br /> DESC. Z 'L ���4�,LS <br /> OWNER ADDRESS aP PMONE <br /> P/4VIp C71DOS g2n2 S1rA�FURST fl�. �-"�3 <br /> TENANT NAME I CONTACT NAME PMONE <br /> CONTRACTOR ADDRES9 ZIP CONTR.LICENSEII <br /> �,��ar��uF� ��sr .,��. ,�r�2� Rku� a� qs�:� <br /> PMONE HZ4- ZS`I-72S� <br /> PROPOSED USE OF BUILDIN6 IO� Bullding � MlChaniCal Addition MEA1'90URCE <br /> PERMIT 1I.4.( Combinetion Plumbiny WORK RI..1 niteretbn R Flectrir: <br /> C3U�RlQ6�'C TYPE �,J Demolfllon Sipn TYPE ,� New u Ose <br /> L� Sprinklar RepaidMeint. U OMer <br /> CONTRACT PRICE OF WORK � � W� _ CITY OF EVERETT LOCAL SALES TAX CQCE IS 7106 <br /> WORKDESCRIPTION �µ�R�rro�J O� /f Z��XZ4 ' D/�R�K+R TO �X�STIACls 6(l�Kµ(9!C <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF Fl%TURE OR REM NO. IYPE OF R7(TilpE OR REM <br /> _ WATER CLOSET _ A/C-NHANDLING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> _ IAVATORY(WASH BASIN) _ HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> � DISHWASHER RANGE HOOD <br /> LAUNORY TRAY _ WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL _ FIREPIACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR ORAIN GAS fiANOE <br /> _ BACKFLOW PREVENTER GAS PIPING <br /> _ SINK(SERV�CE/8AR/MOP/ETC.) EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREBY CERITIFY 7HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNCJJ TNE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED WITH WHETHEH SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTFIORI7Y TO VIOIATE OR CANCEL THE PROVISION OF A��V OTHEF <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE?ERFORMANCE OF CON;iTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPEfiTY TO PERFORM THE WORK FOH WHICM APPLICATION IS MAUE AND I COMPLY WITH THE STATE <br /> CONTRAC70RS LAW 18.27 RCW AND 296200 WAC. <br /> .�..�J,/,.t�.L'�C.�.�.._ / / - Z�a-o� <br /> � ignaWre ot Owner/Contractor/Authon2ad Agent ete �� <br />