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� P MIT APPLICATIO� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> SITE ADDRESS PARCEL TAX I.D.A PERMIT M <br /> � �� - -o ,s- ee��q-o� <br /> LEGAL LO O. BLOCK TR CT <br /> DESC. � 3Y fk L <br /> OWNER ADDRESS PHONE_ <br /> (J��:� C���� � �'9a 7 »u,►� �d2� � 36��� 9 � <br /> TENANTNAME I CONTAC7NAME I PHONE <br /> `-- <br /> CONTRACTOR i ADDHESS� r �LS'—�B 03Y 7— ( CONTR. LICENSE k <br /> PHONE <br /> �°�,� v a-u— � <br /> �✓7G �a ,�i�NGvD 99oNL <br /> PROPOSED USE OF BUILDING n Building � Mechanica� Addition HEAT SOURCE <br /> PERMIT ls6'Combination Plumbing WORK -Aitaratbn � Electnc <br /> TYPE r� Demoliti��n Sign TYPE New Gas <br /> � � D Spflnklef air/Maint. Other <br /> CO TRACT PRICE OF WORK �� CIT/OF EVERETT LOCAL SAIES TAl(CODE IS 9f 05 <br /> WOHK�ESC/F�IPTION , �i T <br /> �s frx2�l�l�GuY L! 'f ��Lr�^r a,''f r..,.t�i�ce ��c.� qq // . <br /> ' . g� /�'' � dc Q./�'". <br /> ��,��"``'�°-�`y i w-�,.~s, ���.«�p,� ��.f�- 9 �'�i �� / <br /> . no o�% ..Xtrb /r vn � 7 (�IorR. <br /> Lp UMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM N0. TYPE OF Fl%TURE OR ITEM <br /> ,�, WATER CLOSET _ A/C-AlHANDLING UNITS <br /> BATHTUB /� FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> T CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACEINSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> _ BACKFLOW PNE`/ENTER /� GAS PIPING <br /> _ SINK(SERVICE/8.1R/MOP/ETC.) EXHAUST FAN <br /> — OTHER � � A — OTHER_ — <br /> ���, CJ�. .!� — <br /> I HEFEBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICA'ION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF WWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETFIER SPECIFIED HEREIN OR <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOA WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> (,/S �.._�`� l �fif�'��, Jcj- /� - �� <br /> Signat"i�re of OwnedContractodAuthonzed Agent Date i�� <br />