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� PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VJA 98201 I <br /> 425-257-8810- FAX 425-257-8857 I <br /> i <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI7 3 � <br /> oTu.L�.L S>�E�' �? 7%���L�;� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 21P PHONE <br /> ��P�TT�.or�xr �u,�c�E 1�T�� Sr�ET 987p/ �F1S-.�9-Y�5/3 <br /> TENANTNAM� CONTACTFORPERMIT PHONE <br /> I �/y,e,� �../,4,¢T ¢z5-S88-qS�3 <br /> ICONTRACTOR AUDRESS ZIP CONTR.LICENSE# <br /> PHONE <br /> PROPOSED USE OF BUILDING Building Mechanical ition HEAT SOURCE <br /> ��jG� �.j�/pG�G¢S5�i0�'t PERMIT R�-( Combination Plumbing WORK Alteration -c <br /> TYPE �.,j Demolition Sign IYPE New Gas <br /> L� Spnnkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK � 7�p� �� CITY OF EVERETT LOCAL SAlES TA7C CODE IS J105 <br /> WORKDESCRIPTION �y;-/n//.E�C .fGC- % ��'d ���o� ✓�¢C-l1�4/tAy�E — NSTiant� <br /> �/DCd�c�,F3o.���+-to✓�Ea ^l7f•ti4�ow.���% ✓A-ii�r'�Z� —�iY-o OLl� <br /> Gv/L .¢rl�b�-� '-�<++iST/7LLNA6u.� ��L+�q GO/L� Cl1/7!�[-iEiLJ l�1"''[/� <br /> iy,,,/�g, so.�.� �'uF.c�.uctcLw+9.c.0 �.�rT� aTi�'��sr�.c..-� sc..l� f'o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. I TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HA�JDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS � <br /> _ KITCHEN SINK&DISPOSAL — CLOTHES DRYER I <br /> DISHWASHER RQNGF HOOD <br /> LAUNDRYTRAY WATER HEATER �i <br /> CLOTHES WASHER _ METAL FIREPLACE/5TOVE <br /> �. URINAL _ PIREPLACE INSERT <br /> ' DRINKING FOUNTAIN GAS FIREPLACE � <br /> FLOOR DRAIN GAS RANGE <br /> I BACKFLOW PREVENTER AS PIPING <br /> � SINK(SERVICEi8AR1�40PlETC.) _ XHAUST FANS I <br /> OTHER _ OTHER RE6J/c� Fik�5�^� <br /> —_ ✓ .� � <br /> - -� � u"� I <br /> '. HEREBY CERITIF 'THAT I HAVE READ AND E:{AIdINED T�IS APP�ICA'i ION ANC KNOW TNE SAA1E TO BE TRUE AND CORRECT. ALL li <br /> PRJVISIONS OF L>lVS AND ORIGiNACES GOVERNING TrIS i fPE OF 11'ORK�VILL BE COMPLIED WITH WHE-HER SPECIFIEO HEREIN OR � <br /> 'JOT. TRE GRANTING OF A PERNIT'JOES NOT PRESUME'O GIVE AUTHORITY'0`lIOLr1TE OR CANCEL'NE PFOVISION CF ANY OTHER <br /> STATE OR LOC?�LAW REGUUI7ING CO�VSTRUCTION OR THE?ERFORMANCE OF CONS-RUCTION. THAT I AM AUTHORIZED BV THE I <br /> OVJNE.R OF Th15 PROPERN 70 P[RFORV�THE`.VORK FOR IVHICH APFUCA i ION IS tdADE AND I COMPLY WITH THE STATE I <br /> C NTQ r7HCTORS Ln1h' 18.".7 RCIY. "96.200 WAC. <br /> \ J;�'�/ �, �I �,g ��� . 7' -���T <br /> Signawr of Cwn nContractovAuthonzed Ngent Date �/2 <br /> am�-Siy-o�o/ � <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED � <br />