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PERMIT APPLICATIOiN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 9ES201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE AUURESS PARCEL TAX I.D.# PE AIIT tt <br /> oTu.�.L ST��"" . _—��;� ` - ) <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHCINE <br /> �7'f�iiC�l. CaG�lc�E �LL'b%oi4lf� �f71f�f 98 Zo/ �f,1'.S-,�'99-pS/� <br /> TENA AM --� CONTACTFORPERM�T PHUNE <br /> � � l S ^�� �/r� .�,.-�.a+¢.�— fz5-S8B-9Si3 <br /> CONTRACTOR DRESS ZIP CO��TR.LICENSE N <br /> . .��� -�c�r <br /> PHONE <br /> PROPOSED USE OF BUILDING / � Building Mechanical ition HEA7 SOURCE <br /> ��c��/,L/�,�,f��/ PERMIT Combination Plumbing WORK Alteration nnc <br /> TYPE Demolilion Sign ITYPE New Gas <br /> �(.�¢�,a� l�fL°J�iPj Sprinkle� ReFairlMaim. Other <br /> CONTRACT PRIC[OP WORK ���n �' CITY OF EVERETT LOCAL:iALES TAX CODE IS 3105 <br /> WORKDESCRIPTION P�S ��Zi��g °o ��iYe�,E ,�K/bT/•yc� Raw��aP d.viTs ��/b <br /> s�✓�a� N�,vES�.v.rs) 15`Dd N.Etv /�09��� u�✓�T(.l�v-�� I�� T�!'�E <br /> �,� l��eo� n�rv f�F�.a�.�.Ed r�✓u.�.ir-s F�2 ns�� s�i�wc ..sc.�r.�r7 <br /> s./.f-T1F'.c- ..-uE.v7�iE+tiD v��zE v vr�c��S ��riE /�•v-'�.�.� <br /> �Q� / i ro�/. 5o�t� S7i3*�rlvius� ub�r.�c � ,�►`GI�c7.t»C,fc-- !i�✓.0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS F�P X Lv/ <br /> BATHTUB FORCED AIR SYSTEMS /Sb/t*J�Rl7�i� <br /> _ LAVATORY(WAShI BASIN) HEAT PUMP M�i• <br /> SHOWER UNITHEATERS � <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASH�R RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPL.4CE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FUUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MUP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> II HEREBV CERITIFY THAT I HqVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANfI CORRECT. ALL I <br /> I pROVISIONS OF LAWS APID ORIDI�ACES GOVERNING THIS TVPE OF WORK WILL BE COIdPLIED WITH WHETHER SPEqFIED HEREIN OR � <br /> NOT. THE GRFNTING OF A PERMIT DOES NOT PRESUAIF TO GIVE AUTHORI iY TO VIOLATE OR CAI�CEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUWTING CONSTRUCTION OR THE PERFORAtANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8'f THE <br /> 01h'NER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> C NTRACTOR LAW 18.27 RCW AND 6.200 WAC. <br /> `�i.�GG.-i �• �/�---� l�"�d, w�2. 7�-/-D'¢— <br /> Signature f Owner/ oniractodAuthonzed Agent Date <br /> �' f2�-��� DESIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />