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PERMIT 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 <br />PARCEL TAX I.D. A <br />EF IT a <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />DON 217GfLC'1✓ <br />TENANT NAME I <br />CONTACT NAME PHONE <br />CONTRACTOR ADDRESS ZIP CONTR. LK:ENSEA <br />Q.OB/NSJN tot V/YJQ/,vb /NL/ 2Q330 /14fiF .J✓C NF 1%8223 02.06SN DIRT-7 tCL <br />PHONE C3hJ ) <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />Addition <br />NEAT SOURCE <br />PERMIT <br />Combination 5 Plumbing <br />WORK P <br />Alleretionj�ElectricTYPEDemolitionSlgnTYPE <br />� <br />� <br />New <br />B Oea <br />Sprinkler <br />Repeir/Maml. <br />Osier <br />CONTRACT PRICE OF WORK P, /'q/ oo o <br />CRY OF EVERETT LOCAL (ALES TAX CODE If 0106 <br />WORK DESCRIPTION <br />r-,vr sP/L/�ctcz' SycS7rr-i Pce1t <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR REM <br />NO. TYPE OF FIXTURE OR REM <br />WATER CLOSET <br />A/C - A/HANDLING UNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) BASIN) <br />SEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISPOSAL <br />CLOTHES DRYER <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />_ <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />OACKFLOW PREVENTER <br />GAS PIPING <br />_ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />OTHER_ <br />OTHER_ <br />-- <br />Z� <br />SP.Q,r.�cc.7p Mestt7s' <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRVE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT "rRESl1A1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS A 296.200 WAG. <br />/LAIW r18/.RCW <br />Signature of Owner/Contractor/Authorized Agent <br />