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� <br /> • ' P�3MIT APPLICATIC�.� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> 6�.?v4-ozo <br /> SITE ADDRESS PARCEL TAX I.D.R PERMi7� <br /> 1 -rN� R ri A�0 ' �J <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OW ER ADDRESS LP PMONE <br /> I� 3 �,vr��cAz►s�S <br /> TENANT NAME I CONTACT NAME PHONE <br /> CONTRACTO AOONESS 2IP CONTR.UCENSE N <br /> ,4CL �luNi3 ,w��jT s�i4 lyoh p�. ti.�. Mw�� w,a 96� �9�ttPGVifo�l�y <br /> PHONE�3e�) Gs3 -i�i�� (�«��y��1-�sy-�-sec � <br /> PROPOSED USE OF BUILDING Building Mechenical Addition MEAT SOURCE <br /> PERMIT Combinalion Plum6ing WORK Alterelion Q Eiectric <br /> TYPE � Demolition � Sign ITYPE � Naw I �J Gas <br /> L� Sprinkler 1.� Repeir/blainL L� Other <br /> CONTRACT PRICE OF WORK I� �y,r, CITV OF EVERETT LOCAI 9ALE3 TA%CODE IS 010.5 <br /> � ��V <br /> WORK DESCRIPTON <br /> �LvmQiNb <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM NO. TYPE OF Fl%TURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BA'HTUB FORCED AIR SYSTEMS <br /> L�IVATORY(WASH BASIN) HEAT PUMP <br /> Z S�iOWER UNIT;IEATERS <br /> � KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> I _ DISHWASHEF — RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> � CLOTHES WASHER METAI FIREPIACE/STOVE <br /> UFINAL _ FIREPLACE INSERT <br /> � _ DRINKING FOUNTAIN GAS FIREPLACE <br /> I FLOOR DRAIN _ GAS RANGE <br /> � BACKFLOW PREVENTER _ GAS PIPING <br /> � -- <br /> I _ S�NK (SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHEF S�R41(B F}7� OTHER <br /> I _ <br /> I <br /> I HEREBV CERITIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF L1WS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTP.UCTION OFi THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTMOR12ED BV TME <br /> OWNEFi OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH APPIICATION IS MADE AND I COMPLY WITH TME STATE <br /> CON CTORS l�AJ'18. RCW A D 296.200 WAC. <br /> ' �Y � -���D Z <br /> ure wner/Contractor/AuthorizedAgert Date <br /> � `/L <br />