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_ ---� l <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> PARCEL TAX I.D.N PERMIT M <br /> SITE ADDRESS �3 —p/c, <br /> ZO V�PSHI a 00 O O3S <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRES LP PHONE + <br /> D,�. �n,r� c�kzo wPsaTNhT�u AvE ���T 982o3-�IzS)3553`11E <br /> TENANTNAME <br /> CONTACTNAME PHONE � <br /> SRMrr. a�. ��� I �� KN Q,r- K-��� Car�sr. 3�� ��s-2� . <br /> CONTFACTOR utY�O N ADDHESS 21P CONTR•UCENSE M $ <br /> -Fou2 eonsrr �0109 K-tNwlw�i+�+a,ve <br /> PHONE(3w��bg-�sa SNoko►�•�s� wA- 9a29� KF'ouRC.R�o�PP <br /> PROPOSED USE OF BUILDING R! Building D Mechanlcal Addltion HEAT SOURCE <br /> PERMIT K Combinelion U Plumbing WORK �tera�l � Elearfc <br /> TYPE �_� Demolition U Sign TMPE Repair/Mafnt. Other <br /> Si IG Fj4►��1 �Si&�L� U Sprinkler <br /> CONTRACT PRICE OF WORK �Q�OOO �� /� J i�� CITY OF EVERETT LOCAL RALES TA%CODE 18�f 06 <br /> WOHK DESCRIPTION 4"//x`,� ✓^ ;''� �v � <br /> ,?e.►t�Pe( .�+e i�7t 9Q.ni'c-9G iNTD �%�yt �DOM � tr6lw¢ � �uM�,{ l.'I�-�"/a-f� P0.''"$' <br /> ,�e.e1�'1Z� en.a,f'�t'�5 �eu�a� att'�� �tF0U�4'S l�J [LncQ rHisa�/�A�woowS tFv fihlS��. , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF Fl%TURE OR REM <br /> WATER CLOSET _ NC—AIHANDLING UNITS <br /> BATHTUO _ FORCEU AIR SYSTEMS <br /> LAVATORY(WASIi 6ASIN) _ HEAT PUMP <br /> SHOWER ._ UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL _ CLOTHES ORYER <br /> DISHWASHER _ RANGE FIOOD <br /> LAUNDRYTRAY _ WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ OAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPINO <br /> SINK(SERVICElBARfMOP/ETC.) _ EXHAUS7 FAN <br /> OTHER _ ._ OTHER <br /> I HEREBY CEf71TIfY THAT I IIAVE(iFAD AND EXAIdINED iHIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF lAWS AND OIiIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OH <br /> NOT. TIi[GRANTING OF A PEfiM1T DOES NOT PRESUME TO GIVE AUTNOfiITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTF'ORIZED BY THE <br /> OWNER Of T111S PROPEFTY TO PERFORM THE WORK FOR VJHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR�CTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �1--� , 3-1�..-oz <br /> Si nalure ol OwnedContraclod ulhonted Agent e1e ��L <br />